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We aimed at evaluating any differences with a systematic review and meta-analysis. PubMed, MEDLINE, and EMBASE databases were last searched on 6\/2\/2021 to identify English randomized controlled trials (RCTs), prospective cohort and retrospective independent database studies published between Jan 1, 2010 and Dec 31, 2020 reporting perioperative outcomes following robotic hysterectomy versus laparoscopic, open, or vaginal approach (PROSPERO #CRD42022352718). Twenty-four articles were included that reported on 110,306 robotic, 262,715 laparoscopic, 189,237 vaginal, and 554,407 open patients. The robotic approach was associated with a shorter hospital stay (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.00001), less blood loss (<jats:italic>p<\/jats:italic>\u2009=\u20090.009), and fewer complications (OR: 0.42 [0.27, 0.66], <jats:italic>p<\/jats:italic>\u2009=\u20090.0001) when compared to the open approach. The main benefit compared to the laparoscopic and vaginal approaches was a shorter hospital (R\/L WMD: \u2013\u00a00.144 [\u2013\u00a00.21, \u2013\u00a00.08], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001; R\/V WMD: \u2013\u00a00.39 [\u2013\u00a00.70, \u2013\u00a00.08], <jats:italic>p<\/jats:italic>\u2009=\u20090.01). Other benefits seen were sensitive to the inclusion of database studies. Study type differences in outcomes, a lack of RCTs for robotic vs. open comparisons, learning curve issues, and limited robotic vs. vaginal publications are limitations. While the robotic approach was mainly comparable to the laparoscopic approach, this meta-analysis confirms the classic benefits of minimally invasive surgery when comparing robotic hysterectomy to open surgery. We also reported the advantages of robotic surgery over vaginal surgery in a patient population with a higher incidence of large uterus and prior surgery.<\/jats:p>","DOI":"10.1007\/s11701-023-01724-6","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T06:01:48Z","timestamp":1697695308000},"page":"2647-2662","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":80,"title":["Robotic-assisted benign hysterectomy compared with laparoscopic, vaginal, and open surgery: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"17","author":[{"given":"Louis","family":"Lenfant","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffroy","family":"Canlorbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00e9mie","family":"Belghiti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usha Seshadri","family":"Kreaden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April E.","family":"Hebert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Nikpayam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Uzan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henri","family":"Aza\u00efs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,19]]},"reference":[{"key":"1724_CR1","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1097\/AOG.0000000000004679","volume":"139","author":"JD Wright","year":"2022","unstructured":"Wright JD, Huang Y, Li AH, Melamed A, Hershman DL (2022) Nationwide estimates of annual inpatient and outpatient hysterectomies performed in the United States. 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Goffroy Canlorbe and Dr. J\u00e9r\u00e9mie Belghiti reported consulting for Intuitive Surgical Inc outside the submitted work. Usha Seshardri Kreaden is an employee of Intuitive Surgical and Dr. April Hebert is a scientific consultant for Intuitive Surgical Inc. Drs. Louis Lenfant, Marianne Nikpayam, Catherine Uzan, and Henri Aza\u00efs have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study does not require ethics committee approval because it deals with previously published work.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}