Table 3: Comparative observational studies evaluating the da vinci robotic system (DRS) versus open surgery (OS) or Laparoscopy (LSC) to perform robotic radical hysterectomies (RRH), abdominal radical hysterectomies (ARH), or Laparoscopic radical hysterectomies (LRH) for cervical cancer and a comparative observational study of DRS versus OS and LSC to perform ovarian cancer staging and debulking surgeries.

SurgeryNRRH versus ARHRRH versus LRHControlSurg-eonOR time (min.)EBL (mL)Hospital stay (days)Lymph node countConversionsBld TxIntraoperative complicationsPostoperative complications

Radical hysterectomy
Magrina [92]
2003–2006
Mayo ClinicPhoenix, AZ
Matched: age, BMI, malignancy, stage, type of radical
27 versus 35
27 versus 31
HC + CC
HC + CC
Pro-Spective
NR190 versus 167
190 versus 220
133 versus 444
133 versus 208
1.7 versus 3.6
1.7 versus 2.4
26 versus 28
26 versus 26
NoneRRH: 4%
ARH:9%
LRH: 0%
RRH: 0
ARH: 6%
Bleeding (2)
LRH: 3%
Rectotomy (1)
RRH: Major 7% Pleural effusions (1), pneumothorax (1)
Minor: 15% urinary retention (1), UTI (2), bleeding (1)
ARH: Major 9%
Pna (1), wound seroma (1), ileus (1)Minor: 9% urinary retention (1), emesis (2)
LRH: Major 6%
Fever (1), port-site infection (1)
Minor: 10% corneal abrasion (1), urinary retention (1), lymphatic drainage at cuff (1)

Boggess et al. [81]
2005–2007
UNC
Matched: stage
51 versus 49HC
Pro-Spective
NR211 versus 24897 versus 4171 versus 3.234 versus 23NoneRRH: 0%
ARH:8%
NRRRH: 8%
Cuff abscess (1), lymphedema (1), readmission (1), cuff dehiscence (1)
ARH: 16%
Femoral n. injury (2), ileus (1), lymphocyst (1), bleeding (1), cuff dehiscence (1), wound infection (2)

Geisler [93]
2007-2008
Toledo, OH
30 versus 30HC
Pro-spective
NR154 versus 166165 versus 3231.4 versus 2.825 versus 26noneNRNRUrinary retention
POD no. 8
RRH: 27%
ARH: 3%
90 days post-op: ND

Estape [94]
2006–2008
South Miami Hospital
Matched: stage and histology
32 versus 14
32 versus 17
HC
HC
Pro-spective
DS144 versus 114
144 versus 132
130 versus 621
130 versus 210
2.6 versus 4.0
2.6 versus 2.3
32 versus 26
32 versus 19
NRRRH: 3%
ARH: 36%
LRH: 0%
RRH: 3%
Cystotomy (1)
ARH: 0%
LRH: 12%
Cystotomy (2)
RRH: 19%
Atelectasis/COPD (1), fever (1), ileus (1), wound cellulitis (1), pelvic abscess (1), cuff dehiscence (1)ARH: 29%
Pna (1), SVT (1), ureter dilation (1), urine retention (1)
LRH: 24%
Fever (1), hypo-K (1), ileus (1), fistula (1)

Maggioni et al. [95]
2007–2009
Milan, Italy
40 versus 40HC
Pro-spective
DS272 versus 20078 versus 2213.7 versus 5.020 versus 26NRRRH: 8%
ARH: 23%
RRH: 5%
Nerve injury (1), intestinal injury (1)
ARH: 10%
Cystotomy (1) ureteral injury (2), intestinal injury (2)
RRH: 30%
Subcutaneous emphysema (4), fever (3), infection (1), nerve palsy (2), pleural effusion (1), reintervention (1)
ARH: 25%
Fever (12), infection (3), ileus (1), nerve palsy (3), pleural effusion (2), reintervention (1)

Nam et al. [96]
2006–2009
Seoul, Korea
Matched: Age, BMI, stage, histology, prior surgeries, radical type
32 versus 32HC
Pro-Spective
DS218 versus 209220 versus 53211.6 versus 16.920 versus 24NRRRH:  3%
ARH:  64%
RRH:  3%
Rectotomy
ARH: 0%
RRH: 84%
Infection (2), fever (7), pleural effusion (2), bladder dysfunction (5), ileus (4), diarrhea (1), wound dehiscence (1), neuropathy (1), lymphedema (1), readmit (2), ureteral stricture (1)ARH: 59%
Infection (1), fever (9), pleural effusion (1), bladder dysfunction (3), ileus (2), wound dehiscence (3)

Sert and Albert [97]
2005–2009
Norway
35 versus 26
35 versus 7
HC
HC
Pro-specitve
NR263 versus 163
263 versus 364
82 versus 595
82 versus 164
3.8 versus 9.2
3.8 versus 8.4
20 versus 26
20 versus 15
NRNRRRH: 9%
Cystotomy (3)ARH: 0
LRH: 14%
Cystotomy (1)
RRH: 11%Lymphocyst (2), lymphedema (1), DVT (1)
ARH: 46%Lymphocyst (1), lymphedema (2), UTI (7), pna (2),
LRH: 71%Lymphocyst (3), UTI (1), compartment syndrome (1)

Tinelli et al. [98]
2003–2010
Avellino, Italy
& Mount Sinai, New York, NY
23 versus 76CC
Pro-spective
DS255 versus 32395 versus 1574 versus 3Pelvic: 27 versus 25
Aortic:12 versus 10
none0RRH: 9%
Cystotomy (2)
LRH: 3%
Cystotomy (2)
RRH: 9%
Lymphorrhea (2), fever (2)
LRH: 21%
Fistula (1), fever (6), lymphorrhea (9)

Ovarian cancer debulking
Magrina et al. [99]
2004–2008
Mayo Clinic Phoenix, AZ
Matched: age, BMI, type debulking
25 versus 119
25 versus 27
HC + CC
Pro-spective
HC + CC
NR315 versus 261
315 versus 254
164 versus 1307
164 versus 267
4.2 versus 9.4
4.2 versus 3.2
25 versus 23
25 versus 21
NRNRDRS: 12%
Cystotomy (2), vessel injury (1)
OS: 13%
Bleeding (6), GI injury (6), cystotomy (2), ureteral injury (2)
LSC: 11%
Enterotomy (1), bleeding (1), vessel injury (1)
DRS: 24%
Cuf dehiscence (2), pleural effusion (1) bleeding (1), ileus (1), trocar-site infection (1), pulmonary edema (1)
OS: 34%
Wound complications (10), GI (11), CV (7), pulmonary (7), UTI(2), abscess (2), hematoma (1), anastamotic leak → death (1)
LSC: 4%
Pelvic abscess (1)

Hisoric conrols (HC), Concurrent controls (CC), same surgeon(s) (SS), different surgeon(s) (DS), estimated blood loss (EBL), not reported (NR). Sample size (N). When not specified, DRS outcomes are reported first. Items in bold are significantly different determined by a two-sided alpha . Outcomes are reported as means unless otherwise noted.