Robotic surgery vs. traditional laparoscopy in gynecology: When, why, and what to expect
Author(s): Kajal Kumar Patra and Bibekananda Das
Abstract: Minimally invasive surgery has transformed gynecologic practice, with conventional laparoscopy long established as a safe, efficient, and cost-effective standard for many benign and selected malignant conditions. The introduction of robotic-assisted surgery has expanded the technical capabilities of minimally invasive gynecology through enhanced three-dimensional visualization, wristed instrumentation, tremor filtration, and improved surgeon ergonomics. This chapter critically examines robotic surgery versus traditional laparoscopy in gynecology, focusing on clinical indications, patient selection, workflow differences, outcomes, safety considerations, learning curves, and cost-effectiveness. Evidence consistently shows that in routine benign procedures, clinical outcomes are broadly comparable between platforms, with laparoscopy often retaining advantages in efficiency and cost. Robotic surgery demonstrates its greatest value in selected complex cases—such as large uteri, dense adhesions, deep infiltrating endometriosis, and suturing-intensive reconstructive procedures—where it may reduce technical difficulty, surgeon fatigue, and, in experienced programs, conversion to laparotomy. However, robotics introduces distinct risks, including loss of tactile feedback, altered energy-related injury patterns, and dependence on team coordination, particularly the bedside assistant. In gynecologic oncology, platform choice must remain evidence-driven, with careful adherence to oncologic principles and ongoing outcomes audit. Ultimately, robotic surgery should be viewed as a capability extender rather than a replacement for high-quality laparoscopy. Safe, cost-effective adoption depends on appropriate case selection, structured training, team-based workflows, governance, and continuous evaluation of outcomes that matter most to patients and health systems.
Pages: 36-46 | 135 Views | 54 Downloads
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