Review of the role of robotic surgery in male infertility

• Published in: Arab Journal of Urology Vol. 16; no. 1; pp. 148 - 156
• Main Authors: Etafy, Mohamed, Gudeloglu, Ahmet, Brahmbhatt, Jamin V., Parekattil, Sijo J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier B.V 01.03.2018; Taylor & Francis; Elsevier
• Subjects: assisted reproductive technology; FDA; Management; Medical Subject Heading; MeSH; Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PRISMA; randomised controlled trial; RAVE; RAVV; RAVx; RCT; robot-assisted microsurgical varicocelectomy; robot-assisted microsurgical vasoepididymostomy; robot-assisted vasovasostomy; Robotic testicular sperm extraction; Robotic varicocelectomy; Robotic vasectomy reversal; Robotic vasoepididymostomy (RAVE); Robotic vasovasostomy; TESE; testicular sperm extraction; three-dimensional; ultrasonography; USA Food and Drug Administration; Robotic vasectomy reversal; FDA; RCT; ART; TESE; PRISMA; MeSH; RAVV; Robotic varicocelectomy; 3D; Robotic vasoepididymostomy (RAVE); RAVx; RAVE; Robotic testicular sperm extraction; Robotic vasovasostomy; US; FDA, USA Food and Drug Administration; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; RAVx, robot-assisted microsurgical varicocelectomy; ART, assisted reproductive technology; 3D, three-dimensional; RAVE, robot-assisted microsurgical vasoepididymostomy; RAVV, robot-assisted vasovasostomy; RCT, randomised controlled trial; TESE, testicular sperm extraction; MeSH, Medical Subject Heading; US, ultrasonography
• ISSN: 2090-598X; 2090-5998; 2090-598X; 2090-5998
• DOI: 10.1016/j.aju.2017.11.006

To present the current state of the art in various robot-assisted microsurgical procedures in male infertility and review the latest literature, as the technology in infertility procedures has substantially developed since the incorporation of the Vinci® robotic platform (Intuitive Surgical, Inc., Sunnyvale, CA, USA). The search strategy in this review was conducted in accordance with Cochrane guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A search strategy was conducted in MEDLINE, PubMed and the Cochrane electronic databases (from 2000 to present) to identify studies that included both robotic and male infertility. In all, 23 studies were found, 12 of which met our inclusion criteria. Articles were excluded if the study did not include both male infertility and robotics. Robotic assistance for microsurgical procedures in male infertility appears to be safe and feasible. It has several advantages including elimination of tremor, multi-view magnification, additional instrument arms, and enhanced dexterity with articulating instrument arms. It also has a short learning curve with a small skin incision. However, larger, prospective studies are needed to establish the clinical benefits over standard microsurgery.