• Munazzah Rafique, Tehmina Aziz, and Sahar Al-Suwailem.
• Women Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia.
• J Coll Physicians Surg Pak. 2020 Mar 1; 30 (3): 254-258.

ObjectiveTo compare the outcomes of robot-assisted (RA) and standard laparoscopic gynecological surgery (S-LGS) in a tertiary care hospital, and evaluate the factors affecting the outcomes of RA-LGS to identify areas of improvement.Study DesignA descriptive study.Place And Duration Of StudyKing Fahad Medical City, Riyadh, Saudi Arabia, from 2013 to 2018.MethodologyIn this 5-year retrospective study, 65 LGS cases, including 37 RA-LGS and 28 S-LGS, in a single tertiary care hospital, were included. Demographic data, clinical pathological details, and complications of the cases were recorded. Surgeons performing RA-LGS were also interviewed regarding their training/experience, competency of surgical assistance, and suggestions for improving training.ResultsOperative times (3.70 ±0.96 vs. 2.07 ±0.78 h, p <0.001) and hospital stays (3.53 ±3.29 vs. 1.96 ±1.34 days, p=0.022) were significantly longer in the RA-LGS group than in the S-LGS group. Intraoperative complications, which were primarily adjacent organ damage (21.6% vs. 0.0%, p=0.029), were significantly more common in the RA-LGS group. There were no significant differences between the groups in terms of the need to convert to laparotomy, immediate/late postoperative complications, estimated blood loss, or the need for blood transfusion. The interview survey results suggested the lack of a trained team assisting in RA-LGS, as the reason for the poor outcomes.ConclusionThere were no advantages of RA-LGS over S-LGS. Longer training periods for RA-LGS, with minimum 20-50 cases as part of a structured training programme, may improve outcomes.

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