Table 3.
Characterization of all studies of robotic-assisted pelvic/perineum reconstruction with greater than 10 patients.
| Author (Year) | Type of Study | Level of Evidence | Population | Cohort size | Control group | Mean age (%female) | Inclusion Criteria | Exclusion Criteria | Mean Follow-Up | Outcomes Measured | Results | Comments |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Chong et al., 2015 | Retrospective | IV | Patients undergoing abdominoperineal reconstruction with gracilis flap from 2010-2012 Dallas, TX |
16 | N/A | 62 ± 8 years (31.3%) |
Not reported | Not reported | 5-40 months | OR time Major and minor perineal complication Donor site complication Abdominal wound complication Deep venous thrombosis 30 day mortality Hospitalization Days until ambulation |
Major perineal wound complication: 6% minor perineal complication: 19% Gracilis donor site surgical site infection: 3 (19%) Abdominal surgical-site infections: 4 (25%) No abdominal, parastomal, or perineal hernias or bulges No flap losses |
|
| Dy et al., 2021 | Retrospective | IV | Transgender women undergoing Robotic-assisted peritoneal flap gender-affirming vaginoplasty (RPGAV) New York City, NY |
100 (Xi = 47; SP = 53) |
N/A | 36.2 years (Not reported) |
Not reported | Patients with <6 mo of follow-up were excluded. | 11.9 months | Perioperative details (operative time and blood loss) Complications (intra- and postoperative) Postoperative neovaginal dimensions (patient-reported maximum dilator depth and size at the most recent follow-up) |
Average procedure times were 4.2 and 3.7 h in Xi and SP cohorts (p <0.001). Complications: Transfusion (6%) - 5 (11%) in Xi and 1 (2%) in SP system (p = 0.01) Vaginal stenosis (7%) - 6 (13%) in Xi and 1 (2%) in SP system (p = 0.003) Rectovaginal fistula (1%) - 0 in Xi and 1 (2%) in SP system (p = 0.181) Bowel obstruction (2%) - 0 in Xi and 2 (4%) in SP system (p = 0.057) |
Comparing da Vinci Xi robot (Xi) vs. da Vinci Single Port (SP) robot |
| Dy et al., 2021 | Retrospective | IV | Patients underwent robotic peritoneal flap revision vaginoplasty from 2017 to 2020 New York City, NY |
24 transgender women | N/A | 39 years (100%) |
Robotic peritoneal flap revision vaginoplasty Primary penile inversion vaginoplasty or vulvoplasty 6-month follow up appointment |
Not reported | 13.5 months | Postoperative neovaginal dimensions complications |
No intraoperative peritoneal flap harvest complications Post-operative: 1: Bleeding from a prostatic neurovascular bundle requiring perineal suture ligation under anesthesia. 2: granulation tissue at the junction of the neovaginal skin and peritoneal flap 1: curettage and surgical release of scar tissue at 5 months post-op 1: curettage of granulation tissue at 6 months post-op |
Revision vaginoplasty using robotic transabdominal canal dissection and harvest of peritoneal flaps 4 patients (17%) lost to further follow up Small sample size Short follow up |