Anthony A Luciano1, Danielle E Luciano1, Jessica Gabbert2, Usha Seshadri-Kreaden3. 1. Center for Fertility and Women's Health, Obstetrics and Gynecology, Hospital of Central Connecticut, New Britain, CT, USA. 2. InClin, Department of Biometrics, San Matteo, CA, USA. 3. Intuitive Surgical, Department of Clinical Affairs, Sunnyvale, CA, USA.
Abstract
BACKGROUND: The impact of robotics on benign hysterectomy surgical approach, clinical outcomes, and learning curve is still unclear. METHODS: Review of abdominal, vaginal, laparoscopic, or robotic cases in 156 US hospitals in the Premier Research Database. RESULTS: Of 289 875 hysterectomies, abdominal cases decreased from 2005-2010 (60-33%) and minimally invasive approaches increased (40-67%). Conversion rates were: 0.04% for vaginal, 2.5% for robotic, and 7.2% for laparoscopy (P < 0.001). Robotic surgery time was longest (3.4 h vs. 2.2 vaginal, 2.5 abdominal, 2.7 laparoscopy, P < 0.001). Robotic complication rate was lowest (14.8% vs. 16.2% vaginal, 18.6% laparoscopy, 28.9% abdominal, P < 0.001). Hospital stay was longer following abdominal surgery (3.5 days vs. 1.8 robotic, 1.9 vaginal, 1.8 laparoscopy, P < 0.001). Robotic surgery times and conversion and complication rates improved with experience (2.8 h, 2%, and 13.9%, respectively), even with increasing complexity. CONCLUSIONS: Robotics was successfully incorporated without jeopardizing patient outcomes and increased the overall use of minimally invasive approaches.
BACKGROUND: The impact of robotics on benign hysterectomy surgical approach, clinical outcomes, and learning curve is still unclear. METHODS: Review of abdominal, vaginal, laparoscopic, or robotic cases in 156 US hospitals in the Premier Research Database. RESULTS: Of 289 875 hysterectomies, abdominal cases decreased from 2005-2010 (60-33%) and minimally invasive approaches increased (40-67%). Conversion rates were: 0.04% for vaginal, 2.5% for robotic, and 7.2% for laparoscopy (P < 0.001). Robotic surgery time was longest (3.4 h vs. 2.2 vaginal, 2.5 abdominal, 2.7 laparoscopy, P < 0.001). Robotic complication rate was lowest (14.8% vs. 16.2% vaginal, 18.6% laparoscopy, 28.9% abdominal, P < 0.001). Hospital stay was longer following abdominal surgery (3.5 days vs. 1.8 robotic, 1.9 vaginal, 1.8 laparoscopy, P < 0.001). Robotic surgery times and conversion and complication rates improved with experience (2.8 h, 2%, and 13.9%, respectively), even with increasing complexity. CONCLUSIONS: Robotics was successfully incorporated without jeopardizing patient outcomes and increased the overall use of minimally invasive approaches.
Authors: Paresh C Shah; Alexander de Groot; Robert Cerfolio; William C Huang; Kathy Huang; Chao Song; Yanli Li; Usha Kreaden; Daniel S Oh Journal: Surg Endosc Date: 2022-02-09 Impact factor: 3.453