Low Complication Rates in Robotic Surgery For Endometriosis: Hyderabad Doctor’s Study

Hyderabad: A Hyderabad-based doctor published a new Indian study reporting favourable surgical and recovery outcomes in women undergoing robotic-assisted surgery for endometriosis, including deep infiltrating endometriosis, one of the most complex forms of the disease.

The retrospective study, published in the medical journal Cureus, analysed 108 women, who underwent robotic-assisted surgery between October 2023 and April 2025, using the da Vinci Xi Surgical System.

The research, led by gynaecologist Dr Anitha Kunnaiah, found low intra-operative and post-operative complication rates of just 0.9 per cent each, with no cases requiring conversion to open surgery. Patients also showed improvements in post-operative pain and quality-of-life measures.

Endometriosis affects nearly 10 per cent of women of reproductive age globally and is associated with chronic pelvic pain, infertility and reduced quality of life. The disease is often diagnosed late because symptoms overlap with several gynaecological and gastrointestinal conditions, said Dr Kunnaiah.

“Due to delayed diagnosis and treatment, women often live with chronic pain, fatigue, infertility concerns and reduced quality of life for several years before receiving appropriate care,” she said.

“By the time many patients reach a specialist centre, the disease may already be affecting multiple pelvic structures and significantly impacting their personal, social and reproductive wellbeing. This highlights the importance of greater awareness, earlier detection and timely intervention in women showing persistent symptoms,” she added.

The study found that nearly 40 per cent of patients had deep infiltrating endometriosis, an advanced condition that can affect the bowel, bladder and surrounding pelvic structures. Despite the complexity of the surgeries, the average hospital stay was around 2.2 days. Patients were able to walk independently within an average of 11 hours after surgery and resume normal activities within about 2.2 days after the procedure.

Patients with non-deep infiltrating disease reported nearly 99 per cent reduction in pain scores within seven days after surgery, while women with deep infiltrating endometriosis reported over 90 per cent reduction during the same period. Significant improvements in quality-of-life scores were also noted across both groups.

Dr Kunnaiah said advanced endometriosis surgeries are often technically demanding because they involve operating in confined pelvic spaces while preserving surrounding organs and structures. “The da Vinci Xi surgical system provided visualisation and instrument articulation that supported surgical management in complex cases, particularly in patients with deep infiltrating endometriosis involving multiple pelvic structures,” she said.

“In this study cohort, no conversions to open surgery were reported, while post-operative recovery outcomes and hospital stay duration were also observed to be favourable across patient groups,” she added.

The researchers noted that the findings contribute to the growing Indian evidence evaluating robotic-assisted surgery in complex gynaecological conditions. They added that larger prospective studies with long-term follow-up would help further assess long-term outcomes and cost-effectiveness in the Indian healthcare setting.