A systematic review and meta-analysis of conventional laparoscopic sacrocolpopexy versus robot-assisted laparoscopic sacrocolpopexy.

Abstract

Robot-assisted laparoscopic sacrocolpopexy (RALSC) has spread rapidly without the availability of comprehensive and systematically recorded outcome data. To systematically review and compare the outcomes of laparoscopic sacrocolpopexy (LSC) and RALSC. PubMed and Scopus were searched for reports published from 2000 to 2014, using the search terms "robotic sacrocolpopexy," "laparoscopic sacrocolpopexy," and "sacral colpopexy." Studies were included if they directly compared the outcomes of RALSC and LSC, the sample size in each group was more than 15, the follow-up duration was longer than 3 months, and the report was in English. The studies' characteristics, quality, and outcomes were recorded. Random-/fixed-effects models were used to combine data. Data on 264 RALSC and 267 LSC procedures were collected from seven studies. The mean operative time was longer in the RALSC group (245.9 minutes vs 205.9 minutes; P<0.001). The estimated blood loss in the two groups was similar (114.4 mL vs 160.1 mL; P=0.36). The differences in incidence of intraoperative/postoperative complications were also similar (P=0.85 vs P=0.92). The costs of RALSC were significantly higher than were those of LSC series in each of three studies (P<0.01 for all). The clinical outcomes of prolapse surgery are similar with RALSC and LSC, but RALSC is less efficient in terms of cost and time.