IMR Press / CEOG / Volume 50 / Issue 2 / DOI: 10.31083/j.ceog5002044
Open Access Opinion
Level 1 Evidence for Robotic Surgery for Urological and Gynecological Pelvic Cancers: Where do We Currently Stand?
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1 Unit of Urology, San Paolo Hospital Medical School, ASST Santi Paolo e Carlo, 20142 Milano, Italy
2 Unit of Obstetrics and Gynecology, San Paolo Hospital Medical School, ASST Santi Paolo e Carlo, 20142 Milano, Italy
3 Unit of Obstetrics and Gynecology, San Carlo Hospital, ASST Santi Paolo e Carlo, 20153 Milano, Italy
4 Department of Urology, Tanta University, 31527 Tanta, Egypt
5 Department of Urology, Orsi Academy, 82822 Melle, Belgium
6 San Paolo Bachelor School of Nursing, San Paolo Hospital Medical School, ASST Santi Paolo e Carlo, 20142 Milano, Italy
7 Unit of Urology, University of Modena and Reggio Emilia, 41100 Modena, Italy
8 Department of Health Sciences, University of Milano, 20142 Milano, Italy
*Correspondence: sighinolfic@gmail.com (Maria Chiara Sighinolfi)
Clin. Exp. Obstet. Gynecol. 2023, 50(2), 44; https://doi.org/10.31083/j.ceog5002044
Submitted: 15 August 2022 | Revised: 22 October 2022 | Accepted: 7 November 2022 | Published: 14 February 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Robotic surgery is used for the surgical removal of female pelvic malignancies and encompasses procedures as radical cystectomy and radical hysterectomy. The aim of this paper is to provide an update of level 1 literature evidence about the outcomes of robotic surgery compared to other surgical approaches for the treatment of bladder, endometrial and cervical cancer. A non- systematic search of the PubMed and Scopus databases was conducted to identify peer-reviewed randomized controlled trials (RCTs) comparing surgical approaches for radical cystectomy and hysterectomy. To the purpose of capturing the lastest updates, 2020–2022 literature was reviewed. In the field of radical cystectomy, two RCTs supported the implementation of robotics as a more beneficial approach than open surgery - in terms of faster recovery, less thromboembolic events, less infectious events. In gynecology, despite robotics is accepted for the treatment of early endometrial tumors, the role of minimally invasive surgery (MIS) for the treatment of cervical cancer is still debated, with two recent systematic reviews and meta-analyses reporting conflicting results. Two- decades after the introduction of robotic surgery, there is still a number of current studies evaluating its role for the treatment of urological pelvic malignancies, especially for bladder cancer. The role of robotic surgery alone for the treatment of gynecological malignancies has been scarcely addressed with robotics being mostly evaluated as a part of MIS; updates about MIS for the treatment of cervical cancer continue to be ongoing.

Keywords
robotic surgery
randomized controlled trial
pelvic cancer
prostate cancer
bladder cancer
endometrial cancer
cervical cancer
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