Robotic-assisted hysterectomy in a community hospital after seven years of experience

摘要

The da Vinci robotic-assisted laparoscopic hysterectomy is being widely adopted by healthcare institutions and constitutes the highest percentage of the robotic-assisted surgeries. By now da Vinci robotic-assisted hysterectomy (RAH) is used worldwide, and even so, different aspects of this relatively new surgical technique remain under evaluation. There are contradicting reports in the literature about the superiority of RAH versus conventional laparoscopic hysterectomy (CLH) in terms of patient outcomes and costs. The purpose of this small size study was to contribute to this open question by analyzing patient records in a community hospital with extensive seven years of experience in RAH. The analysis of the data compares the surgical outcomes and patient costs of RAH (n = 23) versus CLH (n = 23). A retrospective study using the electronic chart review was performed. There were no statistically significant differences between the two groups for estimated blood loss, duration of surgery, length of stay, 30-day readmission, and patient costs; however, the average cost of RAH was $3116 less than CLH, if not considering the cost and maintenance of the surgical robot indicating surgical team approaching proficiency and maturity in RAH. A strong correlation between uterus weight, blood loss, duration of surgery, and patient cost within only the RAH group was observed, suggesting a more precise surgical technique. RAH and CLH had similar surgical outcomes. RAH can be a more precise surgical technique, and potentially less costly when the cost and maintenance of the robot are not considered.