Comment on: ‘Money for nothing’. The role of robotic-assisted laparoscopy for the treatment of endometriosis

• Published in: Journal of Robotic Surgery
• Main Authors: Palmeri Matteo, Di Franco Gregorio, Furbetta Niccolò, Morelli Luca
• Other Authors: Palmeri, Matteo, DI FRANCO, Gregorio, Furbetta, Niccolò, Morelli, Luca
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2019
• Subjects: DML
• Online Access: http://hdl.handle.net/11568/939514; https://doi.org/10.1007/s11701-018-00908-9; http://www.haworthpress.com/store/product.asp?sid=LH9C67VBD7PP9PECDFMTMV3RWC3L62U4&sku=J451&AuthType=4

To the Editor: We read with great interest the published article by Berlanda et al. entitled “Money for nothing”. The role of robotic-assisted laparoscopy for the treatment of endometriosis [1]. Deep infiltrating endometriosis (DIE) with colorectal involvement is one of the most aggressive forms of endometriosis. At present, a minimally invasive surgery (MIS) and in particular the direct manual laparoscopy (DML), is considered the gold standard for radical treatment of DIE with colorectal involvement, as it results in faster recovery, reduced in-hospital stay, improved cosmesis, and lower postoperative morbidity compared to laparotomy. Robot-assisted surgery (RAS), is a technological advancement of DML, introduced with the aim to overcome its kinematics limitations. In recent years, the diffusion of the da Vinci System has created much enthusiasm has grown between surgeons of different specialties, with a constantly growing application of RAS, and several studies have been published to describe safety and efficacy of RAS, as well as to compare RAS to DML. In particular, colorectal surgeons and gynecologists have explored RAS and have also applied it to the treatment of DIE [2]. In the article, Berlanda et al. describe a very well structured critical review of the literature about the role of RAS for the treatment of endometriosis. In particular, they reported that RAS treatment of endometriosis did not provide clear benefits over standard laparoscopy, in the face of a longer operative time and higher costs. They, therefore, express concern for economic sustainability in the face of increasing use of the widely diffusion of da Vinci system, and they made conclusions against the use of robot for the treatment of DIE. However, we have noticed that in all of the article the authors uses generically the terms of “robotic-assisted laparoscopy”, without specifying which system they refer to and in truth, the whole study is based on the da Vinci Si system, the most widespread version to date until recently. Indeed, only ...