The current state and the future of robotic surgery in female pelvic medicine and reconstructive surgery

Özet

In this article, we review the current uses and future directions of robotic surgery in the field of femalepelvic medicine and reconstructive surgery. Pelvic surgery is ideal for the use of surgical robots, whichprovide improved visualization and ease of suturing deep within the pelvis. Robots have been success-fully used for the treatment of pelvic organ prolapse, in procedures such as sacrocolpopexy, sacrohys-teropexy, and uterosacral ligament plication. Surgeons have used the robotic successfully to treat vari-ous etiologies of female pelvic pain including fibroids, endometriosis, and nerve entrapment. Roboticrepair of iatrogenic injury has been described with excellent outcomes and avoidance of conversion toopen surgery in the event of an injury caused using the robotic platform. While more data is neededon this topic, there has been increasing interest in using the robot for urologic reconstruction includingrepair of vesico-vaginal fistula, cystectomy, augmentation cystoplasty, and continent and non-continentdiversions. Recently the use of the robot has been described in the treatment of stress urinary incon-tinence in females, with robotic placement of an artificial urinary sphincter. While robotic surgery isassociated with increased cost, the outcomes of robotic surgery in female urology are promising. Morestudies that properly evaluate the benefits of robotic surgery as compared to open and laparoscopicapproaches are needed.