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Robotic-assisted laparoscopic myomectomy versus abdominal myomectomy: a comparative analysis of surgical outcomes and costs

  • General Gynecology
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Abstract

Objective

To compare clinical and effectiveness outcomes between robotic-assisted laparoscopic myomectomy (RALM) and abdominal myomectomy (AM).

Study design

Records were reviewed for the first 27 RALM procedures at our institution. Age, BMI, insurance status, race, uterine size, and operative indication were used to select comparable patients who had undergone AM. Clinical and efficiency outcomes were compared stratifying for uterine size, specimen weight, and matched propensity scores.

Results

IV hydromorphone use was significantly lower for RALM (P < 0.01), with no significant differences in blood loss or complications. RALM patients had significantly shorter hospital stays; however, total hospital charges were higher (P < 0.0001). This likely reflects longer operating room time (P < 0.0001), which was magnified as specimen size increased (P < 0.0001).

Conclusion

RALM patients require less IV hydromorphone, have shorter hospital stays, and have generally equivalent clinical outcomes compared with AM patients. Additionally, as specimen size increased, the operative efficiency of RALM decreased compared with AM.

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Acknowledgments

The authors would like to thank Markus Zei of Northwestern University Feinberg School of Medicine for assistance with medical records review, Mary Mueller of the Northwestern Memorial Hospital Financial Planning Department for data acquisition, and the faculty and staff of the Research & Education for Academic Achievement (REACH) Network for their support. The authors would also like to thank Northwestern University Clinical and Translational Sciences Institute (NUCATS) for their support in part for grant funding by NIH (grant UL1RR025741) and the Evergreen Invitational Grand Prix Women’s Health Grants Initiative.

Conflict of interest

We declare that we have no conflict of interest. Also, we have had full control of all primary data and agree to allow the Journal to review data if requested.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Kate Nash, Guanning Lu, Biftu Mengesha, Christina Lewicky-Gaupp & Alexander Lin

  2. Division of General Internal Medicine and Institute of Healthcare Studies, Northwestern University Feinberg School of Medicine, 750 North Lake Shore Drive 10th Floor, Chicago, IL, 60611, USA

    Joe Feinglass & Charles Zei

  3. Institute for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Joe Feinglass

Authors
  1. Kate Nash
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  2. Joe Feinglass
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  3. Charles Zei
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  4. Guanning Lu
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  5. Biftu Mengesha
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  6. Christina Lewicky-Gaupp
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  7. Alexander Lin
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Corresponding author

Correspondence to Joe Feinglass.

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Nash, K., Feinglass, J., Zei, C. et al. Robotic-assisted laparoscopic myomectomy versus abdominal myomectomy: a comparative analysis of surgical outcomes and costs. Arch Gynecol Obstet 285, 435–440 (2012). https://doi.org/10.1007/s00404-011-1999-2

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  • DOI: https://doi.org/10.1007/s00404-011-1999-2

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