Single-site Versus Multiport Robotic Hysterectomy in Benign Gynecologic Diseases: A Retrospective Evaluation of Surgical Outcomes and Cost Analysis

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To compare the surgical outcomes and costs of robotic-assisted hysterectomy with the single-site (RSSH) or multiport approach (RH).

DESIGN: A retrospective analysis of a prospectively collected database (Canadian Task Force classification II1).

SETTING: A university hospital.

PATIENTS: Consecutive women who underwent robotic-assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for the treatment of benign gynecologic diseases.

INTERVENTIONS: Data on surgical approach, surgical outcomes, and costs were collected in a prospective database and retrospectively analyzed.

MEASUREMENTS AND MAIN RESULTS: The total operative time, console time, docking time, estimated blood loss, conversion rate, and surgical complications rate were compared between the 2 study groups. Cost analysis was performed. One hundred four patients underwent total robotic-assisted hysterectomy and bilateral salpingo-oophorectomy (45 RSSH and 59 RH). There was no significant difference in the indications for surgery and in the characteristics of the patients between the 2 study groups. There was no significant difference between the single-site and multiport approach in console time, surgical complication rate, conversion rate, and postoperative pain. The docking time was lower in the RH group (p = .0001). The estimated blood loss and length of hospitalization were lower in the RSSH group (p = .0008 and p = .009, respectively). The cost analysis showed significant differences in favor of RSSH.

CONCLUSION: RSSH should be preferred to RH when hysterectomy is performed for benign disease because it could be at least as equally effective and safe with a potential cost reduction. However, because of the high cost and absence of clear advantages, the robotic approach should be considered only for selected patients.

Original languageEnglish
Pages (from-to)603-9
Number of pages7
JournalJournal of Minimally Invasive Gynecology
Volume23
Issue number4
DOIs
Publication statusPublished - Feb 24 2016

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Female Genital Diseases
Robotics
Hysterectomy
Costs and Cost Analysis
Ovariectomy
Databases
Advisory Committees
Operative Time
Postoperative Pain
Hospitalization

Keywords

  • Journal Article

Cite this

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title = "Single-site Versus Multiport Robotic Hysterectomy in Benign Gynecologic Diseases: A Retrospective Evaluation of Surgical Outcomes and Cost Analysis",
abstract = "OBJECTIVE: To compare the surgical outcomes and costs of robotic-assisted hysterectomy with the single-site (RSSH) or multiport approach (RH).DESIGN: A retrospective analysis of a prospectively collected database (Canadian Task Force classification II1).SETTING: A university hospital.PATIENTS: Consecutive women who underwent robotic-assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for the treatment of benign gynecologic diseases.INTERVENTIONS: Data on surgical approach, surgical outcomes, and costs were collected in a prospective database and retrospectively analyzed.MEASUREMENTS AND MAIN RESULTS: The total operative time, console time, docking time, estimated blood loss, conversion rate, and surgical complications rate were compared between the 2 study groups. Cost analysis was performed. One hundred four patients underwent total robotic-assisted hysterectomy and bilateral salpingo-oophorectomy (45 RSSH and 59 RH). There was no significant difference in the indications for surgery and in the characteristics of the patients between the 2 study groups. There was no significant difference between the single-site and multiport approach in console time, surgical complication rate, conversion rate, and postoperative pain. The docking time was lower in the RH group (p = .0001). The estimated blood loss and length of hospitalization were lower in the RSSH group (p = .0008 and p = .009, respectively). The cost analysis showed significant differences in favor of RSSH.CONCLUSION: RSSH should be preferred to RH when hysterectomy is performed for benign disease because it could be at least as equally effective and safe with a potential cost reduction. However, because of the high cost and absence of clear advantages, the robotic approach should be considered only for selected patients.",
keywords = "Journal Article",
author = "Stefano Bogliolo and Simone Ferrero and Chiara Cassani and Valentina Musacchi and Francesca Zanellini and Mattia Dominoni and Arsenio Spinillo and Barbara Gardella",
note = "Copyright {\circledC} 2016 AAGL. Published by Elsevier Inc. All rights reserved.",
year = "2016",
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doi = "10.1016/j.jmig.2016.02.006",
language = "English",
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TY - JOUR

T1 - Single-site Versus Multiport Robotic Hysterectomy in Benign Gynecologic Diseases

T2 - A Retrospective Evaluation of Surgical Outcomes and Cost Analysis

AU - Bogliolo, Stefano

AU - Ferrero, Simone

AU - Cassani, Chiara

AU - Musacchi, Valentina

AU - Zanellini, Francesca

AU - Dominoni, Mattia

AU - Spinillo, Arsenio

AU - Gardella, Barbara

N1 - Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

PY - 2016/2/24

Y1 - 2016/2/24

N2 - OBJECTIVE: To compare the surgical outcomes and costs of robotic-assisted hysterectomy with the single-site (RSSH) or multiport approach (RH).DESIGN: A retrospective analysis of a prospectively collected database (Canadian Task Force classification II1).SETTING: A university hospital.PATIENTS: Consecutive women who underwent robotic-assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for the treatment of benign gynecologic diseases.INTERVENTIONS: Data on surgical approach, surgical outcomes, and costs were collected in a prospective database and retrospectively analyzed.MEASUREMENTS AND MAIN RESULTS: The total operative time, console time, docking time, estimated blood loss, conversion rate, and surgical complications rate were compared between the 2 study groups. Cost analysis was performed. One hundred four patients underwent total robotic-assisted hysterectomy and bilateral salpingo-oophorectomy (45 RSSH and 59 RH). There was no significant difference in the indications for surgery and in the characteristics of the patients between the 2 study groups. There was no significant difference between the single-site and multiport approach in console time, surgical complication rate, conversion rate, and postoperative pain. The docking time was lower in the RH group (p = .0001). The estimated blood loss and length of hospitalization were lower in the RSSH group (p = .0008 and p = .009, respectively). The cost analysis showed significant differences in favor of RSSH.CONCLUSION: RSSH should be preferred to RH when hysterectomy is performed for benign disease because it could be at least as equally effective and safe with a potential cost reduction. However, because of the high cost and absence of clear advantages, the robotic approach should be considered only for selected patients.

AB - OBJECTIVE: To compare the surgical outcomes and costs of robotic-assisted hysterectomy with the single-site (RSSH) or multiport approach (RH).DESIGN: A retrospective analysis of a prospectively collected database (Canadian Task Force classification II1).SETTING: A university hospital.PATIENTS: Consecutive women who underwent robotic-assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for the treatment of benign gynecologic diseases.INTERVENTIONS: Data on surgical approach, surgical outcomes, and costs were collected in a prospective database and retrospectively analyzed.MEASUREMENTS AND MAIN RESULTS: The total operative time, console time, docking time, estimated blood loss, conversion rate, and surgical complications rate were compared between the 2 study groups. Cost analysis was performed. One hundred four patients underwent total robotic-assisted hysterectomy and bilateral salpingo-oophorectomy (45 RSSH and 59 RH). There was no significant difference in the indications for surgery and in the characteristics of the patients between the 2 study groups. There was no significant difference between the single-site and multiport approach in console time, surgical complication rate, conversion rate, and postoperative pain. The docking time was lower in the RH group (p = .0001). The estimated blood loss and length of hospitalization were lower in the RSSH group (p = .0008 and p = .009, respectively). The cost analysis showed significant differences in favor of RSSH.CONCLUSION: RSSH should be preferred to RH when hysterectomy is performed for benign disease because it could be at least as equally effective and safe with a potential cost reduction. However, because of the high cost and absence of clear advantages, the robotic approach should be considered only for selected patients.

KW - Journal Article

U2 - 10.1016/j.jmig.2016.02.006

DO - 10.1016/j.jmig.2016.02.006

M3 - Article

C2 - 26898895

VL - 23

SP - 603

EP - 609

JO - Journal of Minimally Invasive Gynecology

JF - Journal of Minimally Invasive Gynecology

SN - 1553-4650

IS - 4

ER -