Skip to main content
Top
Published in: Journal of Robotic Surgery 1/2010

01-05-2010 | Original Article

Robotically assisted hysterectomy: 100 cases after the learning curve

Authors: Thomas N. Payne, Francis R. Dauterive

Published in: Journal of Robotic Surgery | Issue 1/2010

Login to get access

Abstract

To report on perioperative outcomes of robotic hysterectomy after the learning curve, we performed a retrospective review of our second 100 consecutive robotic hysterectomies performed by two surgeons between January 2007 and February 2008. Operative time following our learning curve was 79.3 ± 36.1 min. Patient age was 44.2 ± 9.6 years, body mass index (BMI) was 30.9 ± 8.3 kg/m2, and uterine weight was 223.7 ± 195.8 g. Indications for surgery included fibroids, menstrual disorders, and endometriosis. We performed total robotic-assisted laparoscopic hysterectomy type IVE. There were no conversions, no blood transfusions, and one cystotomy, repaired intraoperatively. Blood loss was 68.8 ± 105.8 cc, and average length of stay was 1.1 ± 0.3 days. There were no postoperative complications. Perioperative outcomes demonstrate low average operative times with a high level of safety on a broadened patient population, suggesting a potential advantage to using the robotic platform.
Literature
1.
go back to reference Farquhar CM, Steiner CA (2002) Hysterectomy rates in the United States 1990–1997. Obstet Gynecol 99:229–234CrossRefPubMed Farquhar CM, Steiner CA (2002) Hysterectomy rates in the United States 1990–1997. Obstet Gynecol 99:229–234CrossRefPubMed
2.
go back to reference Wilcox LS, Koonin LM, Pokras R, Strauss LT, Xia Z, Peterson HB (1994) Hysterectomy in the United States, 1988–1990. Obstet Gynecol 83:549–555CrossRefPubMed Wilcox LS, Koonin LM, Pokras R, Strauss LT, Xia Z, Peterson HB (1994) Hysterectomy in the United States, 1988–1990. Obstet Gynecol 83:549–555CrossRefPubMed
4.
go back to reference Reich H (1989) New techniques in advanced laparoscopic surgery. Baillieres Clin Obstet Gynaecol 3:655–681CrossRefPubMed Reich H (1989) New techniques in advanced laparoscopic surgery. Baillieres Clin Obstet Gynaecol 3:655–681CrossRefPubMed
5.
6.
go back to reference Bonilla DJ, Mains L, Whitaker R, Crawford B, Finan M, Magnus M (2007) Uterine weight as a predictor of morbidity after a benign abdominal and total laparoscopic hysterectomy. J Reprod Med 52:490–498PubMed Bonilla DJ, Mains L, Whitaker R, Crawford B, Finan M, Magnus M (2007) Uterine weight as a predictor of morbidity after a benign abdominal and total laparoscopic hysterectomy. J Reprod Med 52:490–498PubMed
7.
go back to reference Kreiker GL, Bertoldi A, Larcher JS, Orrico GR, Chapron C (2004) Prospective evaluation of the learning curve of laparoscopic-assisted vaginal hysterectomy in a university hospital. J Am Assoc Gynecol Laparosc 11:229–235CrossRefPubMed Kreiker GL, Bertoldi A, Larcher JS, Orrico GR, Chapron C (2004) Prospective evaluation of the learning curve of laparoscopic-assisted vaginal hysterectomy in a university hospital. J Am Assoc Gynecol Laparosc 11:229–235CrossRefPubMed
9.
go back to reference Wu JM, Wechter ME, Geller EJ, Nguyen TV, Visco AG (2007) Hysterectomy rates in the United States, 2003. Obstet Gynecol 110:1091–1095PubMed Wu JM, Wechter ME, Geller EJ, Nguyen TV, Visco AG (2007) Hysterectomy rates in the United States, 2003. Obstet Gynecol 110:1091–1095PubMed
11.
go back to reference Muzii L, Basile S, Zupi E, Marconi D, Zullo MA, Manci N, Bellati F, Angioli R, Benedetti Panici P (2007) Laparoscopic-assisted vaginal hysterectomy versus minilaparotomy hysterectomy: a prospective, randomized, multicenter study. J Minim Invasive Gynecol 14:610–615. doi:10.1016/j.jmig.2007.05.012 CrossRefPubMed Muzii L, Basile S, Zupi E, Marconi D, Zullo MA, Manci N, Bellati F, Angioli R, Benedetti Panici P (2007) Laparoscopic-assisted vaginal hysterectomy versus minilaparotomy hysterectomy: a prospective, randomized, multicenter study. J Minim Invasive Gynecol 14:610–615. doi:10.​1016/​j.​jmig.​2007.​05.​012 CrossRefPubMed
12.
go back to reference David-Montefiore E, Rouzier R, Chapron C, Darai E (2007) Surgical routes and complications of hysterectomy for benign disorders: a prospective observational study in French university hospitals. Hum Reprod 22:260–265. doi:10.1093/humrep/del336 CrossRefPubMed David-Montefiore E, Rouzier R, Chapron C, Darai E (2007) Surgical routes and complications of hysterectomy for benign disorders: a prospective observational study in French university hospitals. Hum Reprod 22:260–265. doi:10.​1093/​humrep/​del336 CrossRefPubMed
13.
go back to reference Kluivers KB, Hendriks JC, Mol BW, Bongers MY, Bremer GL, de Vet HC, Vierhout ME, Brolmann HA (2007) Quality of life and surgical outcome after total laparoscopic hysterectomy versus total abdominal hysterectomy for benign disease: a randomized, controlled trial. J Minim Invasive Gynecol 14:145–152. doi:10.1016/j.jmig.2006.08.009 CrossRefPubMed Kluivers KB, Hendriks JC, Mol BW, Bongers MY, Bremer GL, de Vet HC, Vierhout ME, Brolmann HA (2007) Quality of life and surgical outcome after total laparoscopic hysterectomy versus total abdominal hysterectomy for benign disease: a randomized, controlled trial. J Minim Invasive Gynecol 14:145–152. doi:10.​1016/​j.​jmig.​2006.​08.​009 CrossRefPubMed
15.
go back to reference Advincula AP, Reynolds RK (2005) The use of robot-assisted laparoscopic hysterectomy in the patient with a scarred or obliterated anterior cul-de-sac. JSLS 9:287–291PubMed Advincula AP, Reynolds RK (2005) The use of robot-assisted laparoscopic hysterectomy in the patient with a scarred or obliterated anterior cul-de-sac. JSLS 9:287–291PubMed
16.
go back to reference Beste TM, Nelson KH, Daucher JA (2005) Total laparoscopic hysterectomy utilizing a robotic surgical system. JSLS 9:13–15PubMed Beste TM, Nelson KH, Daucher JA (2005) Total laparoscopic hysterectomy utilizing a robotic surgical system. JSLS 9:13–15PubMed
17.
go back to reference Marchal F, Rauch P, Vandromme J, Laurent I, Lobontiu A, Ahcel B, Verhaeghe JL, Meistelman C, Degueldre M, Villemot JP, Guillemin F (2005) Telerobotic-assisted laparoscopic hysterectomy for benign and oncologic pathologies: initial clinical experience with 30 patients. Surg Endosc 19:826–831. doi:10.1007/s00464-004-9122-4 CrossRefPubMed Marchal F, Rauch P, Vandromme J, Laurent I, Lobontiu A, Ahcel B, Verhaeghe JL, Meistelman C, Degueldre M, Villemot JP, Guillemin F (2005) Telerobotic-assisted laparoscopic hysterectomy for benign and oncologic pathologies: initial clinical experience with 30 patients. Surg Endosc 19:826–831. doi:10.​1007/​s00464-004-9122-4 CrossRefPubMed
22.
23.
25.
go back to reference Lowe MP, Chamberlain DH, Kamelle SA, Johnson PR, Tillmanns TD (2009) A multi-institutional experience with robotic-assisted radical hysterectomy for early stage cervical cancer. Gynecol Oncol. doi:10.1016/j.ygyno.2009.01.018 Lowe MP, Chamberlain DH, Kamelle SA, Johnson PR, Tillmanns TD (2009) A multi-institutional experience with robotic-assisted radical hysterectomy for early stage cervical cancer. Gynecol Oncol. doi:10.​1016/​j.​ygyno.​2009.​01.​018
27.
go back to reference Johns DA, Carrera B, Jones J, DeLeon F, Vincent R, Safely C (1995) The medical and economic impact of laparoscopically assisted vaginal hysterectomy in a large, metropolitan, not-for-profit hospital. Am J Obstet Gynecol 172:1709–1715 (Discussion 1715–1719)CrossRefPubMed Johns DA, Carrera B, Jones J, DeLeon F, Vincent R, Safely C (1995) The medical and economic impact of laparoscopically assisted vaginal hysterectomy in a large, metropolitan, not-for-profit hospital. Am J Obstet Gynecol 172:1709–1715 (Discussion 1715–1719)CrossRefPubMed
28.
go back to reference Marana R, Busacca M, Zupi E, Garcea N, Paparella P, Catalano GF (1999) Laparoscopically assisted vaginal hysterectomy versus total abdominal hysterectomy: a prospective, randomized, multicenter study. Am J Obstet Gynecol 180:270–275CrossRefPubMed Marana R, Busacca M, Zupi E, Garcea N, Paparella P, Catalano GF (1999) Laparoscopically assisted vaginal hysterectomy versus total abdominal hysterectomy: a prospective, randomized, multicenter study. Am J Obstet Gynecol 180:270–275CrossRefPubMed
29.
go back to reference Perino A, Cucinella G, Venezia R, Castelli A, Cittadini E (1999) Total laparoscopic hysterectomy versus total abdominal hysterectomy: an assessment of the learning curve in a prospective randomized study. Hum Reprod 14:2996–2999CrossRefPubMed Perino A, Cucinella G, Venezia R, Castelli A, Cittadini E (1999) Total laparoscopic hysterectomy versus total abdominal hysterectomy: an assessment of the learning curve in a prospective randomized study. Hum Reprod 14:2996–2999CrossRefPubMed
30.
go back to reference Makinen J, Johansson J, Tomas C, Tomas E, Heinonen PK, Laatikainen T, Kauko M, Heikkinen AM, Sjoberg J (2001) Morbidity of 10,110 hysterectomies by type of approach. Hum Reprod 16:1473–1478CrossRefPubMed Makinen J, Johansson J, Tomas C, Tomas E, Heinonen PK, Laatikainen T, Kauko M, Heikkinen AM, Sjoberg J (2001) Morbidity of 10,110 hysterectomies by type of approach. Hum Reprod 16:1473–1478CrossRefPubMed
31.
go back to reference Seracchioli R, Venturoli S, Vianello F, Govoni F, Cantarelli M, Gualerzi B, Colombo FM (2002) Total laparoscopic hysterectomy compared with abdominal hysterectomy in the presence of a large uterus. J Am Assoc Gynecol Laparosc 9:333–338CrossRefPubMed Seracchioli R, Venturoli S, Vianello F, Govoni F, Cantarelli M, Gualerzi B, Colombo FM (2002) Total laparoscopic hysterectomy compared with abdominal hysterectomy in the presence of a large uterus. J Am Assoc Gynecol Laparosc 9:333–338CrossRefPubMed
32.
go back to reference Falcone T, Paraiso MF, Mascha E (1999) Prospective randomized clinical trial of laparoscopically assisted vaginal hysterectomy versus total abdominal hysterectomy. Am J Obstet Gynecol 180:955–962CrossRefPubMed Falcone T, Paraiso MF, Mascha E (1999) Prospective randomized clinical trial of laparoscopically assisted vaginal hysterectomy versus total abdominal hysterectomy. Am J Obstet Gynecol 180:955–962CrossRefPubMed
33.
go back to reference Benassi L, Rossi T, Kaihura CT, Ricci L, Bedocchi L, Galanti B, Vadora E (2002) Abdominal or vaginal hysterectomy for enlarged uteri: a randomized clinical trial. Am J Obstet Gynecol 187:1561–1565CrossRefPubMed Benassi L, Rossi T, Kaihura CT, Ricci L, Bedocchi L, Galanti B, Vadora E (2002) Abdominal or vaginal hysterectomy for enlarged uteri: a randomized clinical trial. Am J Obstet Gynecol 187:1561–1565CrossRefPubMed
34.
go back to reference Ribeiro SC, Ribeiro RM, Santos NC, Pinotti JA (2003) A randomized study of total abdominal, vaginal and laparoscopic hysterectomy. Int J Gynaecol Obstet 83:37–43CrossRefPubMed Ribeiro SC, Ribeiro RM, Santos NC, Pinotti JA (2003) A randomized study of total abdominal, vaginal and laparoscopic hysterectomy. Int J Gynaecol Obstet 83:37–43CrossRefPubMed
35.
go back to reference Ahlering TE, Skarecky D, Lee D, Clayman RV (2003) Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. J Urol 170:1738–1741CrossRefPubMed Ahlering TE, Skarecky D, Lee D, Clayman RV (2003) Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. J Urol 170:1738–1741CrossRefPubMed
36.
go back to reference Burgess SV, Atug F, Castle EP, Davis R, Thomas R (2006) Cost analysis of radical retropubic, perineal, and robotic prostatectomy. J Endourol 20:827–830CrossRefPubMed Burgess SV, Atug F, Castle EP, Davis R, Thomas R (2006) Cost analysis of radical retropubic, perineal, and robotic prostatectomy. J Endourol 20:827–830CrossRefPubMed
37.
go back to reference Bell MC, Torgerson J, Seshadri-Kreaden U, Suttle AW, Hunt S (2008) Comparison of outcomes and cost for endometrial cancer staging via traditional laparotomy, standard laparoscopy and robotic techniques. Gynecol Oncol 111:407–411CrossRefPubMed Bell MC, Torgerson J, Seshadri-Kreaden U, Suttle AW, Hunt S (2008) Comparison of outcomes and cost for endometrial cancer staging via traditional laparotomy, standard laparoscopy and robotic techniques. Gynecol Oncol 111:407–411CrossRefPubMed
38.
go back to reference Cook JA, Ramsay CR, Fayers P (2004) Statistical evaluation of learning curve effects in surgical trials. Clin Trials 1:421–427CrossRefPubMed Cook JA, Ramsay CR, Fayers P (2004) Statistical evaluation of learning curve effects in surgical trials. Clin Trials 1:421–427CrossRefPubMed
Metadata
Title
Robotically assisted hysterectomy: 100 cases after the learning curve
Authors
Thomas N. Payne
Francis R. Dauterive
Publication date
01-05-2010
Publisher
Springer-Verlag
Published in
Journal of Robotic Surgery / Issue 1/2010
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI
https://doi.org/10.1007/s11701-010-0174-2

Other articles of this Issue 1/2010

Journal of Robotic Surgery 1/2010 Go to the issue