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Comparative analysis of vaginal versus robotic-assisted hysterectomy for benign indications

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Abstract

We aimed to compare perioperative outcomes of robotic-assisted hysterectomy versus vaginal hysterectomy in patients with benign gynecologic conditions, using a retrospective chart review of 240 consecutive benign hysterectomies from May 2008 to April of 2010 performed by a single surgical team at the Eisenhower Medical Center. The analysis included an equal number of cases in each group: 120 robotic-assisted total laparoscopic hysterectomies and 120 total vaginal hysterectomies. Consecutive cases met the inclusion criteria of benign disease. There were no statistically significant differences related to age, body mass index, history of prior abdominal surgery, or uterine weight. Operative times in the robotic group were significantly longer by an average of 59 min (p < 0.001). Patients with robotic-assisted hysterectomy had clinically equivalent estimated blood loss (55.5 ml vs. 84.7 ml, p < 0.001) and the intraoperative complication rates were 1.7% vaginal versus 0% robotic (p = 0.156). There was one conversion in the vaginal group due to pelvic adhesions and no conversions in the robotic group. Length of hospital stay was 1 day for both groups. The perioperative complication rates were equivalent between groups (6.7 vs. 11.7%, p = 0.180), but there were more major complications in the vaginal group (0 vs. 3.3%, p = 0.044). We conclude that, in a comparable group of patients, robotic-assisted hysterectomy takes longer to complete but results in fewer major complications.

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Conflict of interest

Dr. Jacome has proctored for Intuitive Surgical (Sunnyvale, CA, USA) and Eisenhower Medical Center is an “epicenter” for robotic surgery. Dr. Jacome performed all surgeries, data collection, and data entry. Frank Chirstian performed the statistical analysis and has no conflicts of interest to disclose. April E. Hebert is a Scientific Consultant for Intuitive Surgical and performed the literature review and provided manuscript preparation assistance. None of the authors own stock in Intuitive Surgical.

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Authors and Affiliations

  1. Department of Gynecology, Eisenhower Medical Center, 72780 Country Club Dr. Suite A103, Rancho Mirage, CA, 92270, USA

    Enrique G. Jacome & Frank Christian

  2. Intuitive Surgical, Sunnyvale, CA, USA

    April E. Hebert

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  1. Enrique G. Jacome
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  2. April E. Hebert
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  3. Frank Christian
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Correspondence to Enrique G. Jacome.

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Jacome, E.G., Hebert, A.E. & Christian, F. Comparative analysis of vaginal versus robotic-assisted hysterectomy for benign indications. J Robotic Surg 7, 39–46 (2013). https://doi.org/10.1007/s11701-012-0339-2

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  • DOI: https://doi.org/10.1007/s11701-012-0339-2

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