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Total Laparoscopic Hysterectomy With and Without Robotic Assistance: A Prospective Controlled Study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
2014 (English)In: Surgical Innovation, ISSN 1553-3506, Vol. 21, no 3, 250-255 p.Article in journal (Refereed) Published
Abstract [en]

Background. Hysterectomies are very common, and most of them are still performed abdominally. The minimally invasive alternatives are perceived as difficult by gynecologists. Robotic assistance is thought to facilitate laparoscopic surgery. The aim of this study was to compare the surgical outcomes of robotic-assisted and conventional total laparoscopic hysterectomy. Methods. Patients, candidate to hysterectomy for benign indications, were allocated to either robotic or conventional laparoscopy in a quasi-randomized fashion. Patients were operated following a standardized surgical protocol. Main outcome measures were total surgical time, conversions to laparotomy, blood loss, hospital stay, and complications. Results. Fifty-one patients underwent robotic hysterectomy (mean age = 46.59 years) and 54 conventional laparoscopy (mean age = 50.02 years). The groups were homogeneous in body mass index and uterine weight. Robotic-assisted hysterectomies were significantly shorter (154.63 +/- 36.57 vs 185.65 +/- 42.98 minutes in the control group; P =.0001). Patients in the robotic group also had a significantly smaller reduction in hemoglobin (9.69% +/- 8.88% vs 15.29% +/- 8.39% in controls; P =.0012) and hematocrit (10.56% +/- 8.3% vs 14.89% +/- 8.11%; P =.008). No intraoperative conversions to laparotomy were required. Complication rate was low and similar in both groups. All patients were fully recovered at 1-month follow-up outpatient visit. Conclusions. Significantly lower operative times and blood loss indicate that robotic assistance can facilitate surgery already during the learning curve period. Nevertheless, proficiency can be reached in conventional laparoscopy through training, and the cost-effectiveness of robotic hysterectomy for benign conditions is yet to be confirmed.

Place, publisher, year, edition, pages
2014. Vol. 21, no 3, 250-255 p.
Keyword [en]
robotic hysterectomy, total laparoscopic hysterectomy, prospective study, operative time, blood loss, controlled study
National Category
Surgery Obstetrics, Gynecology and Reproductive Medicine
URN: urn:nbn:se:uu:diva-228808DOI: 10.1177/1553350613492023ISI: 000337577100005OAI: oai:DiVA.org:uu-228808DiVA: diva2:735083
Available from: 2014-07-22 Created: 2014-07-22 Last updated: 2014-07-22Bibliographically approved

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