Mortality Rates in Laparoscopic and Robotic Benign Gynecologic Surgery- A Systemic Review and Meta-Analysis

Abstract

Study Objective review mortality rates in benign gynecologic laparoscopic and robotic surgery (MIS), and to evaluate the mortality rates associated with commonly performed MIS procedures. Design Meta-analysis. Setting NA Patients or Participants An electronic-based search was performed on Pubmed, Embase, Scopus, Web of Science, and Cochrane Database. All MIS studies in benign gynecology reporting operative mortality (within 30 days) were reviewed. Meta-analysis was applied to calculate pooled mortality rates using the inverse-variance method. The relative risks (RRs) and their corresponding 95% confidence intervals (95% CIs) were calculated using the Mantel-Haenszel method. Interventions Meta-analysis. Measurements and Main Results 21 articles (12,5738 patients) were included. Operative mortality from any benign MIS (laparoscopy and robotics) procedure was 1:4243 (95% CI 1:1573- 1:11450). Studies were then grouped based on surgical procedure. Mortality rate for hysterectomy (43,112 patients) was 1:4920 (95% CI 1:2233, 1:10845); for sacrocolpopexy was 1:1246 (95% CI 1:36, 1:44700); and for adnexal surgery and diagnostic laparoscopy was 1:2245 (95% CI 1:45, 1:113372). Seventeen studies reported operative mortality for laparoscopic surgery, and 4 for robotic surgery. Conclusion Operative mortality in benign minimally invasive gynecologic surgery is low. There is no major difference for laparoscopic and robotic approaches.