Partial cystectomy for bladder endometriosis: Robotic assisted laparoscopy versus standard laparoscopy

Objectives. - To compare robot-assisted laparoscopy (RL) and conventional laparoscopy (CL) in surgery for bladder endometriosis. Methods. - A retrospective study was conducted between January 2007 and December 2013, including patients with bladder endometriosis receiving at least a partial cystectomy by RL or CL. The primary endpoint was the presence of a radiological recurrence at bladder level. Results. - We included 15 patients in the RL group and 22 in the CL group. The median age was 29 years +/- 7 years. The symptoms were similar in the 2 groups. Pre-surgical mapping of the lesions was carried out with MRI. Sixty percent of patients in the RL group vs 91% in the CL group had other associated endometriosis lesions, P = 0.04. The median size of the bladder lesion was 30 +/- 8 mm in the RL group vs 23 +/- 7 mm in the CL group, P = 0.03. The median operative time was 210 vs 225 min, P = 0.8. We did not find any significant difference in intraoperative and early and late postoperative complications between the 2 groups. The median length of stay was 5 days vs 6 days. The proportion of relapse was 20 vs 23%, P > 0.05. Clinical improvement was similar. between the groups, i.e. 93 vs 86%, P = 0.6 and the pregnancy rate was 93 vs 86%, P = 0.6. Conclusions. - Robot-assisted laparoscopy in the surgical treatment of bladder endometriosis as compared to traditional laparoscopy doe's not seem to have an adverse effect neither on the risk of recurrence nor on the occurrence of intra- and postoperative complications. (C) 2016 Elsevier Masson SAS. All rights reserved.