Pluvio J Coronado1, María Fasero2, Javier F Magrina3, Miguel A Herraiz4, José A Vidart4. 1. Department of Obstetrics and Gynecology, Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain. Electronic address: pcoronadom@sego.es. 2. Service of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Madrid, Spain. 3. Department of Gynecologic Surgery, Mayo Clinic Arizona, Scottsdale, Arizona. 4. Department of Obstetrics and Gynecology, Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain.
Abstract
STUDY OBJECTIVE: To compare perioperative outcomes and cost of robotic-assisted and laparoscopic transperitoneal infrarenal para-aortic lymphadenectomy (TIPAL) for treatment of gynecologic malignant conditions. DESIGN: Prospective non-randomized study (Canadian Task Force classification II-2). SETTING: Tertiary center for women's health. PATIENTS: Sixty-two patients with gynecologic cancer operated on by the same surgical team. INTERVENTIONS: Thirty-two patients underwent TIPAL via robotic-assisted laparoscopy, and 30 via conventional laparoscopy. Comparison analyses of perioperative outcomes and estimated costs were performed. MEASUREMENTS AND MAIN RESULTS: There were no differences between robotic-assisted and laparoscopy insofar as age, body mass index, presurgical morbidity, operating time (92.5 minutes for robotics vs 96.6 minutes for laparoscopy), number of aortic nodes (12 vs. 12), hospitalization stay (2 vs. 2 days), or rate of complications (12.5% vs. 13.3%). Blood loss tended to be lower in the robotic group (75.0 vs. 92.5 mL; p = .08). Surgical cost was higher in the robotic group ($3.42 vs. $2.55; p < .001), although hospitalization cost was similar. CONCLUSION: Robotic-assisted and laparoscopy provide similar perioperative outcomes. However, the robotic-assisted approach is associated with higher surgical cost.
STUDY OBJECTIVE: To compare perioperative outcomes and cost of robotic-assisted and laparoscopic transperitoneal infrarenal para-aortic lymphadenectomy (TIPAL) for treatment of gynecologic malignant conditions. DESIGN: Prospective non-randomized study (Canadian Task Force classification II-2). SETTING: Tertiary center for women's health. PATIENTS: Sixty-two patients with gynecologic cancer operated on by the same surgical team. INTERVENTIONS: Thirty-two patients underwent TIPAL via robotic-assisted laparoscopy, and 30 via conventional laparoscopy. Comparison analyses of perioperative outcomes and estimated costs were performed. MEASUREMENTS AND MAIN RESULTS: There were no differences between robotic-assisted and laparoscopy insofar as age, body mass index, presurgical morbidity, operating time (92.5 minutes for robotics vs 96.6 minutes for laparoscopy), number of aortic nodes (12 vs. 12), hospitalization stay (2 vs. 2 days), or rate of complications (12.5% vs. 13.3%). Blood loss tended to be lower in the robotic group (75.0 vs. 92.5 mL; p = .08). Surgical cost was higher in the robotic group ($3.42 vs. $2.55; p < .001), although hospitalization cost was similar. CONCLUSION: Robotic-assisted and laparoscopy provide similar perioperative outcomes. However, the robotic-assisted approach is associated with higher surgical cost.
Authors: John T Miura; Lesly A Dossett; Ram Thapa; Youngchul Kim; Aishwarya Potdar; Hala Daou; James Sun; Amod A Sarnaik; Jonathan S Zager Journal: Ann Surg Oncol Date: 2019-04-04 Impact factor: 5.344
Authors: David Jayne; Alessio Pigazzi; Helen Marshall; Julie Croft; Neil Corrigan; Joanne Copeland; Phil Quirke; Nick West; Tero Rautio; Niels Thomassen; Henry Tilney; Mark Gudgeon; Paolo Pietro Bianchi; Richard Edlin; Claire Hulme; Julia Brown Journal: JAMA Date: 2017-10-24 Impact factor: 56.272