Robotically Assisted vs Laparoscopic Hysterectomy Among Women With Benign Gynecologic Disease

Abstract

YSTERECTOMY FOR BENIGN gynecologic disease is one of the most commonly performed procedures for women. Overall, 1 in 9 women in the United States will undergo the procedure during her lifetime. 1-3 While hysterectomy has traditionally been performed abdominally via laparotomy, vaginally, or by laparoscopy, robotically assisted hysterectomy has been introduced as an alternative minimally invasive approach to hysterectomy. 1,2 The robotic surgical platform received approval from the US Food and Drug Administration in 2005 for the performance of gynecologic procedures and allows a surgeon to perform the procedure at a remote console. 3 Potential benefits of robotic surgery include increased range of motion with the instrumentation, 3-dimensional stereoscopic visualization, and improved ergonomics for the operating surgeon. 3,4 Unlike other procedures such For editorial comment see p 721.

Impact of robotic technology on hysterectomy route and associated implications for resident education

“…15 A decrease in abdominal hysterectomies is a potential benefit as the rates of abdominal hysterectomy have decreased both in hospitals where robotic-assisted hysterectomies are performed as well as in those where it is not. 16 In line with this, we also found a significant decrease in the number of TAH and a significant increase in laparoscopic hysterectomies between the prerobot and postrobot time periods. Ideally robotic hysterectomy would solely replace abdominal hysterectomy.…”

Same-day discharge is feasible and safe in patients undergoing minimally invasive staging for gynecologic malignancies

“…By 2010, robotic hysterectomy accounted for 9.5% of hysterectomies across the country, and 22% of hysterectomies in hospitals with a robotic platform. 5 The utilization of MIS for surgical staging for both endometrial cancer and cervical cancer has increased to approximately 30%. 6,7 In hospitals with robotic platforms, up to 98% of endometrial cancer staging is now being performed via a robotic assisted approach.…”

Laparoscopic hysterectomy; our experience

“…Bunların %80'den fazlası miyoma uteri, anormal uterin kanama, pelvik organ prolapsusu ve endometriozis gibi benign nedenlerle yapılmaktadır (1,2) . İlk laparoskopik histerektominin Reich tarafından 1989'da tanımlanmasına rağmen, 2003 yılında tüm histerektomilerin ancak %11'i laparoskopik olarak gerçekleştirilmiştir (1,3,4) .…”

“…İlk laparoskopik histerektominin Reich tarafından 1989'da tanımlanmasına rağmen, 2003 yılında tüm histerektomilerin ancak %11'i laparoskopik olarak gerçekleştirilmiştir (1,3,4) . 2010 yılına kadar bu oran ancak %20-30'a kadar arttırılabilmiştir (2,5,6) . American Association of Gynecologic Laparoscopists (AAGL) ve American College of Obstetrician and Gynecologist (ACOG) ortak konsensus raporunda laparoskopik histerektominin standart yaklaşım olması gerektiği belirtilmiş olmasına rağmen, günü-müzde histerektomilerin yarıdan fazlası laparotomi ile yapılmaktadır (7,8) .…”