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The effect of increased experience on complications in robotic hysterectomy for malignant and benign gynecological disease

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Abstract

The study objective was to assess the effect of increased experience on complications in robotic hysterectomy for malignant and benign gynecological disease. This is a retrospective cohort study. It is a Canadian Task Force classification II-2 study conducted at the University Hospital, Sweden. The patients were 949 women planned for robotic hysterectomy for malignant (75 %) and benign (25 %) gynecological disease between October 2005 and December 2013. They were continuously evaluated for the rate of intraoperative and postoperative complications up to 1-year post-surgery, the latter according to Clavien–Dindo classification following the introduction of robotic surgery with special awareness of complications possibly related to robot-specific risk factors, the description of refinement of practice and assessment of the effect of these measures. The rate of intraoperative complications, the overall rate of complications and the rate of ≥grade 3 complications decreased from the first to the last time period (4.8 vs 2.6 %, p = 0.037, 34 vs 19 %, p = 0.003 and 13.5 vs 3.2 %, p = 0.0003, respectively). The rate of intraoperative complications and the rate of postoperative complications possibly related to robot-specific risk factors was reduced from the first to the last time period (3.8 vs 0.6 %, p = 0.028 and 7.7 vs 1.5 %, p = 0.003, respectively). In patients undergoing robotic hysterectomy for malignant and benign gynecological disease intraoperative and postoperative complications and complications possibly related to the robotic approach diminish with training, experience and refinement of practice.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Skåne University Hospital, Lund, Sweden

    Celine Lönnerfors, Petur Reynisson, Barbara Geppert & Jan Persson

  2. Lund University, SE-22185, Lund, Sweden

    Celine Lönnerfors, Petur Reynisson, Barbara Geppert & Jan Persson

Authors
  1. Celine Lönnerfors
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  2. Petur Reynisson
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  3. Barbara Geppert
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  4. Jan Persson
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Corresponding author

Correspondence to Celine Lönnerfors.

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Funding

No financial support was received for this study.

Conflict of interest

Jan Persson is a proctor in robotic surgery. Celine Lönnerfors declares she has no conflict of interest. Petur Reynisson declares he has no conflict of interest. Barbara Geppert declares she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. An Institutional Review Board approval was obtained.

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Informed consent was obtained from all individual participants included in this study.

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Lönnerfors, C., Reynisson, P., Geppert, B. et al. The effect of increased experience on complications in robotic hysterectomy for malignant and benign gynecological disease. J Robotic Surg 9, 321–330 (2015). https://doi.org/10.1007/s11701-015-0534-z

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  • DOI: https://doi.org/10.1007/s11701-015-0534-z

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