Has Robotic Surgery an Effective Role in Peri-Partum Hysterectomy?

Background: the increase of caesarean section causes a higher incidence of placental invasion. The abnormal placentation (placenta accreta, placenta increta and placenta percreta) is related to several maternal and foetal mortality and morbidity. The treatment of placenta accreta in based on conservative procedures and surgical options. The aim of this work is to analyse the effectiveness and feasibility of peri-partum hysterectomy.

Methods: In order to realize the analysis of the impact of robotic surgery in peri-partum hysterectomy, the most important medical databases were consulted. We carefully examined a total of 3 papers. In two of these works, we’ve found the report of a robotic hysterectomy used in the treatment of placenta increta. The other paper is a case report of surgical procedure in case of placenta percreta. The benefit of minimally invasive surgery in the management of hysterectomy is wellknown. The robotic peri-partum hysterectomy is a possible surgical approach for selected patients with no evidence of hemodynamic compromise. The peri-partum hysterectomy must be a planned surgery and it is important that expert surgeons practice the procedure.

Conclusion: An adequate counselling related to the procedure and the possible risk must be provided to the patient which is selected to be inducted to robotic assisted laparoscopy. The particular characteristics and the well-known advantages of robotic surgery eventually candidates this type of surgery as a new safe procedure for the peri-partum hysterectomy.

Author(s):

Mattia Dominoni and Barbara Gardella

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