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Comparison of cost and operative outcomes of robotic hysterectomy compared to laparoscopic hysterectomy across different uterine weights

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Abstract

Operative cost and outcomes between robotic and laparoscopic hysterectomy across different uterine weights. Retrospective cohort study including patients undergoing robotic and laparoscopic hysterectomy for benign disease at an Academic university hospital. One hundred and ninety six hysterectomies were identified (101 robotic versus 95 laparoscopic). Demographic and surgical characteristics were statistically equivalent. Robotic group had a higher body mass index (±SD) (32.9 ± 6.5 versus 30.4 ± 7.1, p 0.012) and more frequent history of adnexal surgery (12.9 versus 4.2%, p 0.031). Laparoscopic group had a higher number of concurrent salpingectomy (81 versus 66.3%, p 0.02). Estimated blood loss did not differ between procedures. Compared to robotic hysterectomies, laparoscopic procedures added 47 min (CI: 31–63 min; p < 0.001) of operative time, costed $1648 more (CI: 500–2797; p = 0. 005) and had triple the odds of having an overnight admission (OR = 2.94 CI: 1.34–6.44; p = 0.007). After stratification of cases by uterine weight, the mean operative time difference between the two groups in uteri between 750 and 1000 g and in uteri >1000 g was 81.3 min (CI: 51.3–111.3, p < 0.0001) and 70 min (CI: 26–114, p < 0.005), respectively, in favor of the robotic group. Mean direct cost difference in uteri between 750 and 1000 g and uteri >1000 g was 1859$ (CI: 629–3090, p < 0.006) and 4509$ (CI: 377–8641, p < 0.004), respectively, also in favor of the robotic group. In expert hands, robotic hysterectomy for uteri weighing more than 750 g may be associated with shorter operative time and improved cost profile.

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Authors and Affiliations

  1. Department of Obstetrics & Gynecology, George Washington University Hospital, 2150 Pennsylvania Avenue NW, Suite 6A429, 20037, Washington, DC, USA

    Gaby N. Moawad, Elias D. Abi Khalil, Paul Tyan & Cherie Q. Marfori

  2. George Washington University School of Medicine, Washington, DC, USA

    Michael K. Shu & David Samuel

  3. Department of Surgery, George Washington University Hospital, Washington, DC, USA

    Richard Amdur

  4. Department of Obstetrics & Gynecology, Johns Hopkins Hospital, Washington, DC, USA

    Stacey A. Scheib

Authors
  1. Gaby N. Moawad
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  2. Elias D. Abi Khalil
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  3. Paul Tyan
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  4. Michael K. Shu
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  5. David Samuel
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  6. Richard Amdur
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  7. Stacey A. Scheib
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  8. Cherie Q. Marfori
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Corresponding author

Correspondence to Elias D. Abi Khalil.

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Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Conflict of interest

Author Abi Khalil, Author Tyan, Author Shu, Author Amdur, Author Scheib and Author Marfori declare that they have no conflict of interest. Author Moawad is a speaker for Intuitive surgical and Applied Medical.

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No funding or financial support was received for the study.

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Moawad, G.N., Abi Khalil, E.D., Tyan, P. et al. Comparison of cost and operative outcomes of robotic hysterectomy compared to laparoscopic hysterectomy across different uterine weights. J Robotic Surg 11, 433–439 (2017). https://doi.org/10.1007/s11701-017-0674-4

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  • DOI: https://doi.org/10.1007/s11701-017-0674-4

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