Early evaluation of the feasibility of robot-assisted laparoscopy in the surgical treatment of deep infiltrating endometriosis

Background: Preliminary study of the feasibility of robot-assisted laparoscopy for deep pelvic endometriosis nodule resection.

Methods: Between May 2009 and February 2010, we collected medical and surgical data about deep infiltrating endometriosis resections performed in our institution, using robot-assisted laparoscopy (DA VINCI Intuitive Surgical System(®)).

Results: Six patients were included: four partial bladder and two uterosacral ligament resections. The median age was 29.5 years (24-48). All patients reported chronic pelvic pain, associated with urinary tract symptoms in case of bladder endometriosis. Before surgery, lesion mapping was performed using magnetic resonance imaging for all, and mechanical bowel preparation or double-j stenting were prescribed, depending on the endometriosis location. Surgical procedures median time was 173 minutes (156-244), and median length of stay was 3 days (2-5). Complete resection was possible in all cases. There was no conversion in classical laparoscopy or laparotomy, and no intraoperative complication. Pathology diagnosis of surgical pieces concluded to endometriosis lesion in all cases.

Conclusions: This study shows the feasibility of the robot-assisted laparoscopy in the resection of deep pelvic endometriosis, without increasing of surgical timing, blood loss or intraoperative complications.