LAUSR

OBJECTIVE Review mortality rates in benign gynecologic laparoscopic and robotic surgery (MIS), and rates associated with commonly performed MIS procedures. DATA SOURCES An electronic-based search was performed on Pubmed, Embase, Scopus, Web of Science, and Cochrane Database in the last 10 years published in English, French, German, Spanish and Italian METHODS OF STUDY SELECTION: All MIS articles in benign gynecology reporting operative mortality (within 30 days) were reviewed. TABULATION Articles identified through the search criteria above were independently evaluated by the first two authors. The Newcastle-Ottawa scale for observational studies and Cochrane risk of bias assessment tool for randomized controlled trials were used to assess the risk of bias. Meta-analysis was applied to calculate pooled mortality rates using the inverse-variance method. INTEGRATION AND RESULTS 21 articles (124,216 patients) were included. Operative mortality from any benign MIS (laparoscopy and robotics) procedure was 1:6456 (95 % CI 1:3946, 1:10562). Studies were then grouped based on surgical procedure. Mortality rate for hysterectomy (119,721 patients) was 1:6814 (95% CI 1:4119, 1:11275); for sacrocolpopexy was 1:1246 (95% CI 1:36, 1:44700); and for adnexal surgery and diagnostic laparoscopy was 1:2245 (95% CI 1:45, 1:113372). Eighteen articles reported operative mortality for laparoscopic surgery, and 4 for robotic surgery. CONCLUSION Operative mortality in benign minimally invasive gynecologic surgery is low, and mortality for laparoscopic and robotic approaches appear to be similar.