Endometriosis surgery can be difficult to perform due to fibrosis and severe adhesion. To make this surgery safer, we introduced robotics.

Design: Case studies from our da Vinci Xi and SP surgery series will be shown.

Setting:

All operations were conducted in a general hospital in Japan. Patient positioning was the same irrespective of whether procedures were single port or multi-port.

Patients or Participants:

Four cases suffering from severe and extensive deep endometriosis will be shown to explain the specific techniques used in each of the cases.

Interventions:

Surgeries using the da Vinci Xi system will be Xi hysterectomy, and Xi lower anterior resection. Surgeries using the da Vinci SP system will be SP lower anterior resection, and SP ureteroneocystostomy.

Measurements and Main Results:

No patients underwent blood transfusion, and the maximum operative time was 2hr 50mins. The post-operative courses of all patients were uneventful. Patients could ambulate and take a regular diet the day after surgery.

Conclusion:

Robotic surgery for difficult endometriosis cases is feasible. Both da Vinci Xi and SP robots can be employed on a case-by-case basis and offer safe dissection and a good cosmetic result for patients.