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Comparison of surgical outcomes between robot-assisted laparoscopic hysterectomy and conventional total laparoscopic hysterectomy in gynecologic benign disease: a single-center cohort study

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Abstract

We compared the surgical outcomes of robot-assisted laparoscopic hysterectomy (RAH) and total laparoscopic hysterectomy (TLH). This single-center cohort study compared 139 RAH cases from January, 2017 to September, 2021 and 291 TLH cases between January, 2015 and December, 2020. We retrospectively evaluated surgical outcomes, including total operative time (defined as the time from port wound incision to port wound closure), net operative time (defined as the time from the start of pneumoperitoneum to the end of pneumoperitoneum), estimated blood loss, weight of excised uterus (±adnexa), and overall complications, and the relationship between surgeon experience and operative time, net operative time, and blood loss in RAH and TLH. There was no significant difference in the total operative time between the two groups. Regardless of surgeon experience, the net operative time was significantly shorter in the RAH group than in the TLH group (p <0.001) and the estimated blood loss was significantly lower in RAH cases than in TLH cases (p = 0.01). The net operative time per uterine weight was shorter in the TLH group than that in the RAH group; however, there was no significant difference. RAH resulted in statistically better surgical outcomes in terms of net operative time and blood loss, regardless of surgeon experience. However, net operative time and blood loss also seem to be significantly affected by uterus weight. Large trials are imperative to determine the more effective surgical approach between RAH and TLH for different patient subsets.

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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

No sources of funding were used for this study.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, Japan

    Asumi Okumura, Eiji Kondo, Masafumi Nii, Michiko Kubo-Kaneda, Kenta Yoshida & Tomoaki Ikeda

Authors
  1. Asumi Okumura
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  2. Eiji Kondo
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  3. Masafumi Nii
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  4. Michiko Kubo-Kaneda
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  5. Kenta Yoshida
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  6. Tomoaki Ikeda
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Contributions

AO: Protocol/Project development, Data analysis, Manuscript writing. EK: Protocol/Project development, Data collection, Manuscript editing. KY: Data collection. MN: Data analysis. MK: Data analysis. TI: Protocol/Project development, Manuscript writing.

Corresponding author

Correspondence to Eiji Kondo.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

The Mie Gynecologic Oncology Survey (MGOS) was approved by the institutional review board (No. H2019-164, 10/Oct/2019) and performed according to the ethical standards of the Declaration of Helsinki revised in 2001. This multicenter retrospective study was approved by the Ethics Committee of Mie University Hospital.

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Informed consent was obtained in the form of opt-out consent on the hospital website.

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Not applicable.

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Supplementary Information

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11701_2023_1638_MOESM1_ESM.docx

Supplementary file1 Supplementary Figure Histograms of surgical outcomes. Total operative time (a), net operative time (b), estimated blood loss (c), and uterine weights (d). RAH, robot-assisted laparoscopic hysterectomy; TLH, total laparoscopic hysterectomy (DOCX 138 KB)

Supplementary file2 Supplementary Table Uterine weight and operative time per weight of it (DOCX 14 KB)

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Okumura, A., Kondo, E., Nii, M. et al. Comparison of surgical outcomes between robot-assisted laparoscopic hysterectomy and conventional total laparoscopic hysterectomy in gynecologic benign disease: a single-center cohort study. J Robotic Surg 17, 2221–2228 (2023). https://doi.org/10.1007/s11701-023-01638-3

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  • DOI: https://doi.org/10.1007/s11701-023-01638-3

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