Fertility after colorectal surgery for endometriosis comparing conventional laparoscopy and robotic assisted laparoscopy Should all patients benefit from robotic approach?

AIM: The first objective was to present fertility outcomes following surgery for deep endometriosis with colorectal involvement at an expert endometriosis center, and to compare conventional laparoscopy with robotic-assisted laparoscopy. Secondary objectives included an analysis of pregnancy and obstetric outcomes.

METHODS

We conducted a retrospective, monocentric cohort study involving patients who underwent surgery for endometriosis between February 2019 and January 2023, with colorectal resection and wishing to become pregnant either before surgery or in the immediate postoperative period.

RESULTS

Among the 72 patients wishing to conceive, 23/34 patients (68%) in the robotic-assisted laparoscopy group achieved pregnancy, compared to 25/38 patients (66%) in the conventional laparoscopy group (not significant (NS)). Spontaneous pregnancies occurred in 11/23 patients (48%) and 9/25 patients (36%), respectively (NS). Among those who achieved pregnancy, 18/23 patients (78.3%) in the robotic-assisted laparoscopy group and 21/25 patients (84%) in the conventional laparoscopy group had at least one live birth (NS).

CONCLUSION

Our findings suggest that surgery for deep endometriosis with colorectal involvement, whether performed via robotic-assisted or conventional laparoscopy, yields similar postoperative fertility outcomes.