Robotics and Infertility

  • Sejal Dharia Patel


Surgery in the field of reproduction has traditionally been taught utilizing tradition laparotomy incision. The advantages of the laparotomy approach include depth perception and tactile feedback from the resistance of tissue/organ dynamics. In addition, there is an ease of intraabdominal suturing from the six degrees of freedom afforded from the human wrist. Although a laparotomy is advantageous for the surgeon compared to other surgical techniques, there are disadvantages for the patient, including a large abdominal incision, prolonged hospitalization, increased postoperative analgesic requirements, and increased morbidity.1,2 This has led some surgeons to seek out minimally invasive approaches. The first laparoscopy was described by Ott from Petrograd, who inspected the abdominal cavity using a head mirror and an abdominal wall speculum in 1901, calling the procedure ventroscopy.3 However, it was the first International Symposium of Gynecologic Endoscopy in 1964 that initiated interest in laparoscopic tubal sterilization,4 gamete intrafallopian tubal transfer,5 and other laparoscopic gynecologic procedures in the ensuing four decades.6


Robotic Surgery Surgical System Tubal Ligation Postoperative Analgesic Requirement Peritoneal Access 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Yuen PM, Yu KM, Yip SK, et al. A randomized prospective study of laparoscopy and laparotomy in the management of benign ovarian masses. Am J Obstet Gynecol 1997;177:109–114.PubMedCrossRefGoogle Scholar
  2. 2.
    Lo L, Pun TC, Chan S. Tubal ectopic pregnancy: an evaluation of laparoscopic surgery versus laparotomy in 614 patients. Aust N Z J Obstet Gynecol 1999;39:185–187.CrossRefGoogle Scholar
  3. 3.
    Gunning JE. The history of laparoscopy. J Reprod Med 1974;12:222–226.PubMedGoogle Scholar
  4. 4.
    Siegler AM, Berenyi KJ. Laparoscopy in gynecology. Obstet Gynecol 1969;34:572–577.PubMedGoogle Scholar
  5. 5.
    Steptoe PC. Laparoscopy in gynecology. London: E & S Livingston Ltd.; 1967:1–3.Google Scholar
  6. 6.
    Peterson EP, Behrman SJ. Laparoscopy of the infertile patient. Obstet Gynecol 1970;36:363–367.PubMedGoogle Scholar
  7. 7.
    Stylopoulos N, Rattner D. Robotics and ergonomics. Surg Clin N Am 2003;83:1–12.CrossRefGoogle Scholar
  8. 8.
    Sturges RH, Wright PK. A quantification of manual dexterity. Robotics Computer Integr Manufacturing 1989;6:237–252.CrossRefGoogle Scholar
  9. 9.
    Berguer R, Forkey DL, Smith WD. Ergonomic problems associated with laparoscopic surgery. Surg Endosc 1999;13:466–468.PubMedCrossRefGoogle Scholar
  10. 10.
    Hagberg M. Electromyographic signs of should muscular fatigue in two elevated arm positions. Am J Phys Med 1981;60:111–121.PubMedGoogle Scholar
  11. 11.
    Ballantyne GH. Robotic surgery, telerobotic surgery, telepresence, and telementoring. Surg Endosc 2002;16:1389–1402.PubMedCrossRefGoogle Scholar
  12. 12.
    Margossian H, Garcia-Ruiz A, Falcone T, et al. Robotically assisted laparoscopic microsurgical uterine horn anastomosis. Fertil Steril 1998;70: 530–534.PubMedCrossRefGoogle Scholar
  13. 13.
    Falcone T, Goldberg JM, Margossian H, Stevens L. Robotically assisted laparoscopic microsurgical anastomosis: a human pilot study. Fertil Steril 2000;73:1040–1042.PubMedCrossRefGoogle Scholar
  14. 14.
    Goldberg JM, Falcone T. Laparoscopic microsurgical tubal anastomosis with and without robotic assistance. Hum Reprod 2003;18:145–147.PubMedCrossRefGoogle Scholar
  15. 15.
    Degueldre M, Vandromme J, Huong PT, Cadiere GB. Robotically assisted laparoscopic microsurgical tubal reanastomosis: a feasibility study. Fertil Steril 2000;74:1020–1023.PubMedCrossRefGoogle Scholar
  16. 16.
    Dharia SP, Steinkampf MP, Whitten SJ, Malizia BA. Robotic assisted tubal reanastomosis in a Fellowship Training Program [abstract]. ESHRE Annual Meeting; June 2004; Berlin, Germany.Google Scholar
  17. 17.
    Dharia SP, Steinkampf MP, Whitten SJ, Malizia BA. Robotically assisted tubal sterilization reversal: surgical technique and cost-effectiveness versus conventional surgery [abstract]. American Society for Reproductive Medicine Annual Meeting; October 2004; Philadelphia, PA.Google Scholar
  18. 18.
    Advincula AP, Song A, Burke W, Reynolds RK. Preliminary experience with robot-assisted laparoscopic myomectomy. J Am Assoc Gynecol Laparosc2004;11:511–518.PubMedCrossRefGoogle Scholar
  19. 19.
    Falcone T, Bedaiwy MA. Minimally invasive management of uterine fibroids. Curr Opin Obstet Gynecol 2002;14:401–407.PubMedCrossRefGoogle Scholar
  20. 20.
    Molpus KL, Wedergren JS, Carlson MA. Robotically assisted endoscopic ovarian transposition. J Soc Laparoendosc Surg 2003;7:59–62.Google Scholar
  21. 21.
    Gutt CN, Markus B, Kim ZG, et al. Early experiences of robotic surgery in children. Surg Endosc 2002;16:1083–1086.PubMedCrossRefGoogle Scholar
  22. 22.
    Schoor RA, Ross L, Niederberge C. Robotic assisted microsurgical vassal reconstruction in a model system. World J Urol 2000;21:48.Google Scholar
  23. 23.
    Kuang W, Shin PR, Oder M, Thomas AJ Jr. Robotic-assisted vasovasotomy: a two-layer technique in an animal model. J Urol 2004;65:811–814.Google Scholar
  24. 24.
    Schiff J, Li PS, Goldstein M. Robotic microsurgical vasovasostomy and vasoepididymostomy: a prospective randomized study in a rat model. J Urol 2004;171:1720–1725.PubMedCrossRefGoogle Scholar
  25. 25.
    Kuang W, Shin PR, Matin S, Thomas AJ Jr. Initial evaluation of robotic technology for microsurgical vasovasostomy. J Urol 2004;171:300–303.PubMedCrossRefGoogle Scholar
  26. 26.
    Cadiere GB, Himpens J, Germay O, et al. Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 2001;25:1467–1477.PubMedGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2007

Authors and Affiliations

  • Sejal Dharia Patel
    • 1
  1. 1.Department of Obstetrics and GynecologyThe Ohio State UniversityColumbusUSA

Personalised recommendations