Top

Published in:

Open Access 10-09-2023 | Cystectomy | Research

What is the role of robotic surgery in ovarian cystectomy with fertility preservation?

Authors: Ju Hye Lee, So Yun Park, Kyungah Jeong, Ha Yeoung Yun, Hye Won Chung

Published in: Journal of Robotic Surgery | Issue 6/2023

Abstract

To investigate the role of robotic single-site (RSS) ovarian cystectomy in fertility preservation, which was compared with single-port laparoscopic (SPL) surgery based on AMH changes. We retrospectively analyzed medical records of total 156 patients who underwent SPL (n = 72) or RSS (n = 84) surgery with the da Vinci^® Si or Xi system. The pre/post-operative AMH levels and total diameter of ovarian cysts were measured. In addition to the surgical method, AMH changes were compared according to the laterality, multiplicity, and pathology of ovarian cysts. A comparison of the characteristics of the SPL group and RSS group, revealed that there were no significant differences in the average age, the diameter of the ovarian cyst, and the number of locule. There were also no statistical differences between the pre-operative and post-operative AMH levels and the average surgical time including the docking time in robotic surgery. A comparison based on the surgical methods, revealed that the decrease in post-operative AMH was lower in the RSS group (24.2 ± 35.9%) than in the SPL group (34.9 ± 29.1%) significantly (p = 0.044). In patients with endometriosis, the decrease in AMH was greater, than that in patients without endometriosis. A longer operation time, larger ovarian cysts and multi-locular cysts were associated with lower AMH level in both the SPL and RSS groups (Pearson correlation coefficient: – 0.320, p = 0.0001, – 0.218, p = 0.007, – 0.236, p = 0.003, respectively). RSS ovarian cystectomy could be a promising new therapeutic option for fertility preservation in complex cases to avoid an additional side port.

Hilger WS, Magrina JF, Magtibay PM (2006) Laparoscopic management of the adnexal mass. Clin Obstet Gynecol 49(3):535–548CrossRefPubMed

Kostrzewa M, Wilczyński JR, Głowacka E, Żyła M, Szyłło K, Stachowiak G (2019) One-year follow-up of ovarian reserve by three methods in women after laparoscopic cystectomy for endometrioma and benign ovarian cysts. Int J Gynaecol Obstet 146(3):350–356CrossRefPubMed

Tsolakidis D, Pados G, Vavilis D, Athanatos D, Tsalikis T, Giannakou A et al (2010) The impact on ovarian reserve after laparoscopic ovarian cystectomy versus three-stage management in patients with endometriomas: a prospective randomized study. Fertil Steril 94:71–77CrossRefPubMed

Candiani M, Ottolina J, Posadzka E, Ferrari S, Castellano LM, Tandoi I et al (2018) Assessment of ovarian reserve after cystectomy versus “one-step” laser vaporization in the treatment of ovarian endometrioma: a small randomized clinical trial. Hum Reprod 33:2205–2211PubMedPubMedCentral

Roman H, Auber M, Mokdad C, Martin C, Diguet A, Marpeau L et al (2011) Ovarian endometrioma ablation using plasma energy versus cystectomy: a step toward better preservation of the ovarian parenchyma in women wishing to conceive. Fertil Steril 96:1396–1400CrossRefPubMed

Sendag F, Akdemir A, Oztekin MK (2014) Robotic single-incision transumbilical total hysterectomy using a single-site robotic platform: initial report and technique. J Minim Invasive Gynecol 21:147e51CrossRef

Paek J, Lee J-D, Kong TW, Chang S-J, Ryu H-S (2016) Robotic single-site versus laparoendoscopic single-site hysterectomy: a propensity score matching study. Surg Endosc 30:1043e50CrossRef

de Meritens AB, Kim J, Dinkelspiel H, Chapman-Davis E, Caputo T, Holcomb KM (2017) Feasibility and learning curve of robotic laparoendoscopic single-site surgery in gynecology. J Minim Invasive Gynecol 24:323e8

Gala RB, Margulies R, Steinberg A, Murphy M, Lukban J, Jeppson P et al (2014) Systematic review of robotic surgery in gynecology: robotic techniques compared with laparoscopy and laparotomy. J Minim Invasive Gynecol 21:353–361CrossRefPubMed

10.

Cate RL, Mattaliano RJ, Hession C, Tizard R, Farber NM, Cheung A et al (1986) Isolation of the bovine and human genes for müllerian inhibiting substance and expression of the human gene in animal cells. Cell 45(5):685–698CrossRefPubMed

11.

Moolhuijsen LME, Visser JA (2020) Anti-müllerian hormone and ovarian reserve: update on assessing ovarian function. J Clin Endocrinol Metab 105(11):3361–3373CrossRefPubMedPubMedCentral

12.

van Rooij IA, Broekmans FJ, te Velde ER, Fauser BC, Bancsi LF, de Jong FH et al (2002) Serum anti-Mu¨llerian hormone levels: a novel measure of ovarian reserve. Hum Reprod 17(12):3065–3071CrossRefPubMed

13.

Yim GW, JungYW PJ et al (2010) Transumbilical single-port access versus conventional total laparoscopic hysterectomy: surgical outcomes. Am J Obstet Gynecol 203:26.e1-e6CrossRefPubMed

14.

Wang Y, Ruan X, Lu D, Sheng J, Mueck AO (2019) Effective of laparoscopic endometrioma cystectomy on anti-Mullerian hormone(AMH) levels. Gynecol Endocrinol 35(6):494–497CrossRefPubMed

15.

Berlanda N, Frattaruolo MP, Aimi G, Farella M, Barbara G, Buggio L et al (2017) Money for nothing. The role of robotic-assisted laparoscopy for the treatment of endometriosis. Reprod Biomed Online 35(4):435–444CrossRefPubMed

16.

Soto E, Luu TH, Liu X, Magrina JF, Wasson MN, Einarsson JI et al (2017) Laparoscopy vs robotic surgery for endometriosis (LAROSE): a multicenter, randomized, controlled trial. Fertil Steril 107(4):996–10023CrossRefPubMed

17.

Shin HJ, Yoo HK, Lee JH, Lee SR, Jeong K, Moon HS (2020) Robotic single-port surgery using the da Vinci SP® surgical system for benign gynecologic disease: a preliminary report. Taiwan J Obstet Gynecol 59(2):243–247CrossRefPubMed

18.

Ferrero S, Venturini PL, Gillott DJ, Remorgida V, Maggiore ULR (2012) Hemostasis by bipolar coagulation versus suture after surgical stripping of bilateral ovarian endometriomas: a randomized controlled trial. J Minim Invasive Gynecol 19(6):722–730CrossRefPubMed

19.

Lee HJ, Lee JS, Lee YS (2020) Comparison of serum antimullerian hormone levels after robotic-assisted vs. laparoscopic approach for ovarian cystectomy in endometrioma. Eur J Obstet Gynecol Reprod Biol 249:9–13CrossRefPubMed

Title: What is the role of robotic surgery in ovarian cystectomy with fertility preservation?
Authors: Ju Hye Lee
So Yun Park
Kyungah Jeong
Ha Yeoung Yun
Hye Won Chung
Publication date: 10-09-2023
Publisher: Springer London
Keywords: Cystectomy
Endometriosis
Fertility
Published in: Journal of Robotic Surgery / Issue 6/2023
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI: https://doi.org/10.1007/s11701-023-01704-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

What is the role of robotic surgery in ovarian cystectomy with fertility preservation?

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2023

Comparison of robotic-assisted laparoscopic radical prostatectomy: SP versus XI, a single surgeon experience

Learning curve for robotic rectal cancer resection at a community-based teaching institution

Functional alignment is associated with increased incidence of pre-balance, reduced soft-tissue release, and post-operative pain compared to mechanical alignment in patients undergoing simultaneous bilateral robotic-assisted TKA

Short-term outcomes of da Vinci SP versus Xi for colon cancer surgery: a propensity-score matching analysis of multicenter cohorts

Feasibility of the set-up for the different approaches in robotic head and neck surgery with the Versius Surgical System

Outcomes of totally robotic Roux-en-Y gastric bypass in patients with BMI ≥ 50 kg/m2: can the robot level out “traditional” risk factors?