Robotic-assisted laparoscopic hysterectomy versus conventional laparoscopic hysterectomy for benign gynaecological disease

TY - ABST

T1 - Robotic-assisted laparoscopic hysterectomy versus conventional laparoscopic hysterectomy for benign gynaecological disease

AU - Sloth, Sigurd Beier

AU - Rudnicki, Martin

AU - Gimbel, Helga

AU - Schroll, Jeppe Bennekou

AU - Topsoee, Märta Fink

AU - Settnes, Annette

AU - Nortvig, Helene

AU - Jørgensen, Annemette

AU - Møller, Charlotte

PY - 2015/6/5

Y1 - 2015/6/5

N2 - Background: In May 2015 the Danish Health and Medicines Authority is publishing a national clinical guideline on hysterectomy for benign gynaecological conditions. One of the key issues assessed in the guideline is the effectiveness of robotic-assisted laparoscopic hysterectomy (RALH) versus conventional laparoscopic hysterectomy (LH). Aims: The purpose was to evaluate available evidence on RALH versus LH and to advise surgeons and decision makers in the Danish healthcare system. Methods: A search specialist conducted a systematic literature search. Results were restricted to clinical guidelines, health technology assessments, systematic reviews and randomized controlled trials (RCTs). An expert advisory group (EAG) reviewed the literature. The EAG predefined critical and important outcomes for assessment of the surgical procedures. Two RCTs met the inclusion criteria. A meta-analysis was conducted and the quality of evidence was rated according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Evidence of low quality showed no differences in the critical outcomes: reoperation, lesion of adjacent structures and vaginal cuff dehiscence. For the important outcomes evidence of low quality showed a longer operating time for RALH compared with LH. There were no differences in the other predefined important outcomes. Conclusions: Evidence of low quality did not support a better outcome or fewer complications after RALH when compared with LH. RALH was associated with a longer operating time than LH. Based on the available evidence and patient values and preferences the Danish Health and Medicines Authority gives a weak/conditional recommendation against RALH in the treatment of benign gynaecological conditions.

AB - Background: In May 2015 the Danish Health and Medicines Authority is publishing a national clinical guideline on hysterectomy for benign gynaecological conditions. One of the key issues assessed in the guideline is the effectiveness of robotic-assisted laparoscopic hysterectomy (RALH) versus conventional laparoscopic hysterectomy (LH). Aims: The purpose was to evaluate available evidence on RALH versus LH and to advise surgeons and decision makers in the Danish healthcare system. Methods: A search specialist conducted a systematic literature search. Results were restricted to clinical guidelines, health technology assessments, systematic reviews and randomized controlled trials (RCTs). An expert advisory group (EAG) reviewed the literature. The EAG predefined critical and important outcomes for assessment of the surgical procedures. Two RCTs met the inclusion criteria. A meta-analysis was conducted and the quality of evidence was rated according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Evidence of low quality showed no differences in the critical outcomes: reoperation, lesion of adjacent structures and vaginal cuff dehiscence. For the important outcomes evidence of low quality showed a longer operating time for RALH compared with LH. There were no differences in the other predefined important outcomes. Conclusions: Evidence of low quality did not support a better outcome or fewer complications after RALH when compared with LH. RALH was associated with a longer operating time than LH. Based on the available evidence and patient values and preferences the Danish Health and Medicines Authority gives a weak/conditional recommendation against RALH in the treatment of benign gynaecological conditions.

M3 - Conference abstract for conference

T2 - First Nordic Congress on Gynaecological Endoscopy/Minimal Invasive Gynaecological Surgery

Y2 - 3 June 2015 through 5 June 2015

ER -