Comparative Analysis of Robot-Assisted versus Standard Laparoscopic Resection for Deep Infiltrating Endometriosis: A Prospective Randomized Study of Perioperative Outcomes and Quality of Life
Keywords:
Endometriosis, Laparoscopy, Robotics, Gynecology, Infertility, Resection, Cost-effectivenessAbstract
Objective: To evaluate the efficacy, safety, and cost-effectiveness of robot-assisted laparoscopy (RAL) compared to standard conventional laparoscopy (CL) in the treatment of deep infiltrating endometriosis (DIE) with colorectal involvement.
Methods: A prospective, randomized controlled trial was conducted involving 80 patients diagnosed with DIE. Participants were randomly assigned to two groups: Group A (n=40) underwent RAL using the Da Vinci Xi system, and Group B (n=40) underwent standard CL. Parameters including operative time, estimated blood loss (EBL), complication rates, and postoperative Quality of Life (QoL) were analyzed.
Results: While RAL demonstrated a statistically significant reduction in EBL ($110 \pm 35$ mL vs. $165 \pm 50$ mL, $p < 0.05$) and a shorter hospital stay, operative times were significantly longer in the RAL group. Postoperative complications were comparable between groups. Quality of life improvements at 6 months were similar.
Conclusion: Robot-assisted surgery offers superior ergonomic advantages and reduced blood loss for complex DIE but comes with increased operative time and cost. It should be reserved for cases requiring extensive dissection where standard laparoscopy reaches its technical limits.
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