A Comparison of Operative Times and Surgical Outcomes between Robotic-Assisted and Laparoscopic Hysterectomy from a Single Surgeon Practice

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Study Objective

To compare operative times and perioperative outcomes between robotic-assisted and traditional laparoscopic hysterectomies in an experienced single surgeon practice.

Design

Retrospective analysis of 204 cases from 2008 to 2011.

Setting

Community-based and urban academic hospitals.

Patients

204 women (ages 26-68 yrs) undergoing minimally-invasive hysterectomy for benign indications.

Intervention

Robotic-assisted or laparoscopic supracervical (RALSH or LSH) or robotic-assisted or laparoscopic total (RATLH or TLH) hysterectomy.

Measurements and Main Results

Collectively, 124 supracervical hysterectomies (62 RALSH and 62 LSH) and 80 total hysterectomies (46 RATLH and 34 TLH) were compared within their respective groups. Groups were compared using t-test, ANOVA, or Chi-square analysis. After controlling for uterine weight using a regression model, the median operative time for robotic procedures was longer than the equivalent traditional laparoscopic procedures: 129 vs 68 minutes (RALSH vs LSH, p <0.001) and 103 vs 83 minutes (RATLH vs TLH, p =

Conclusion

In this case series, even after controlling for uterine weight, robotic-assisted hysterectomies took significantly longer to complete. Robotic-assisted operative times varied widely between institutions and were significantly shorter at the community-based hospital. Robotic assistance during supracervical hysterectomy accommodated much larger uteri without significant differences in adverse events, length of stay, or estimated blood loss between robotic-assisted and traditional laparoscopic

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