ABSTRACT
OBJECTIVES: To review the role of robot- assisted laparoscopic colposacropexy (RALCS) as a treatment for pelvic organ prolapse (POP) accordingly with the available literature and our own experience. METHODS: We have analyzed the studies with the results of robot-assisted colposacropexy (RALCS) and others in which this technique is compared with the abdominal (ACS) and/or the laparoscopic approach (LCS), including our own series. The main data collected are surgical time, blood loss, complications, clinical outcomes, quality of life and the different costs of LCS versus RALCS. We have reviewed the last systematic reviews and meta-analysis. RESULTS: Clinical outcomes were similar within both RALCS and LCS, surgical time was a bit longer for the robot-assisted compared with laparoscopy, blood loss was similar, as complications. The costs of RALCS were significantly higher than those of LCS, although we must conseconsider that the different studies used different variables to measure them. CONCLUSIONS: Considering that comparative studies are necessary, it is reasonable to assume that RALCS is a feasible and secure technique for the treatment of POP.
Subject(s)
Pelvic Organ Prolapse/surgery , Robotic Surgical Procedures , Female , Gynecologic Surgical Procedures/methods , Humans , Postoperative Complications/etiology , Sacrum , Urologic Surgical Procedures/methods , VaginaABSTRACT
OBJETIVOS: Revisaremos la posición actual de la colposacropexia realizada mediante laparoscopia asistida por robot como manejo de los prolapsos de órganos pélvicos (POP), aportando las distintas evidencias publicadas en las revisiones disponibles en la literatura actual y nuestra propia serie. MÉTODOS: Comparamos según las series disponibles y la propia experiencia de nuestro Servicio la técnica robótica con otros abordajes disponibles en el arsenal terapéutico actual. Se recogen los datos referentes a tiempo quirúrgico, pérdida sanguínea, complicaciones, resultados clínicos, calidad de vida y coste de las dos técnicas en las últimas revisiones sistemáticas y metanálisis publicados. RESULTADOS: Los resultados clínicos de corrección de los POP con ambos abordajes son similares, el tiempo quirúrgico sigue siendo algo mayor con el acceso robótico con una estimación de pérdida de sangre durante el procedimiento similar. La incidencia de complicaciones intra o postoperatorias también es similar en ambas técnicas. El acceso robótico sigue presentando un coste mayor que el laparoscópico. CONCLUSIONES: Aunque se precisan más estudios comparativos con los otros abordajes disponibles, se debe reconocer al abordaje robótico como una técnica factible, reproducible y segura
OBJECTIVES: To review the role of robot-assisted laparoscopic colposacropexy (RALCS) as a treatment for pelvic organ prolapse (POP) accordingly with the available literature and our own experience. METHODS: We have analyzed the studies with the results of robot-assisted colposacropexy (RALCS) and others in which this technique is compared with the abdominal (ACS) and/or the laparoscopic approach (LCS), including our own series. The main data collected are surgical time, blood loss, complications, clinical outcomes, quality of life and the different costs of LCS versus RALCS. We have reviewed the last systematic reviews and meta-analysis. RESULTS: Clinical outcomes were similar within both RALCS and LCS, surgical time was a bit longer for the robot-assisted compared with laparoscopy, blood loss was similar, as complications. The costs of RALCS were significantly higher than those of LCS, although we must consider that the different studies used different variables to measure them. CONCLUSIONS: Considering that comparative studies are necessary, it is reasonable to assume that RALCS is a feasible and secure technique for the treatment of POP
Subject(s)
Humans , Robotic Surgical Procedures/methods , Urogenital Surgical Procedures/methods , Pelvic Organ Prolapse/surgery , Treatment Outcome , Recovery of Function , Laparoscopy/methodsABSTRACT
Los catéteres doble J se utilizan en Urología en un importante número de patologías. Estos dispositivos contribuyen a solucionar patologías muy prevalentes, como es la litiasis del tracto urinario superior. Ahora bien, existe una sintomatología asociada a los catéteres doble J muy frecuente y que puede condicionar de una forma muy importante la calidad de vida de los pacientes. Aunque esta sintomatología no reviste gravedad en la mayoría de los casos, obliga a un tratamiento médico para solventar estas manifestaciones clínicas en determinados pacientes. Se han utilizado varios tipos de fármacos como los analgésicos, antiinflamatorios, antibióticos, anticolinérgicos y alfa bloqueantes, con resultados variables en esta patología dependiendo de los autores. Consideramos, que disponer de determinados medicamentos puede ayudar a los pacientes a solventar la sintomatología asociada a los catéteres doble J, sobre todo en los primeros días de su inserción. A medio plazo, la sintomatología urinaria está asociada a problemas relacionados con el catéter doble J, por lo que es necesario establecer las medidas necesarias para que estos dispositivos no pierdan sus características físicas, que puedan condicionar esta sintomatología adversa
Double J stents are used in Urology in an important number of pathologies. These devices contribute to solve very prevalent pathologies such as upper urinary tract lithiasis. However, there are very frequent symptoms associated with double J catheters that may produce a very important constraint on the quality of life of patients. Although theses symptoms are not severe in most cases, they require medical treatment to be solved in certain patients. Several types of drugs such as analgesics, anti-inflammatories, antibiotics, anticholinergics and alpha-blockers have been used for this pathology, with variable results depending on the authors. We consider the use of certain drugs may help patients to solve the symptoms associated with double J catheters, mainly the first days after insertion. In the mid term, urinary symptoms are associated with problems related to double J catheter, so it is necessary to establish the proper measures to have this devices not loose their physical characteristics, that may condition these adverse symptoms
