Comparison of robotic surgery and laparoscopy to perform total hysterectomy with pelvic adhesions or large uterus

Li Hsuan Chiu, Ching Hui Chen, Pei Chia Tu, Ching Wen Chang, Yuan Kuei Yen, Wei-Min Liu

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Currently, benefits of robotic surgery in patients with benign gynecological conditions remain unclear. In this study, we compared the surgical outcome of robotic and laparoscopic total hysterectomies and evaluated the feasibility of robotic surgery in cases with pelvic adhesions or large uterus. Materials and Methods: A total of 216 patients receiving total hysterectomy via robotic or laparoscopic approach were included in this study. Of all 216 patients, 88 underwent robotic total hysterectomy and 128 underwent laparoscopic total hysterectomy. All cases were grouped by surgical type, adhesion score, and uterine weight to evaluate the interaction or individual effect to the surgical outcomes. The perioperative parameters, including operation time, blood loss, postoperative pain score, time to full diet resumption, length of hospital stay, conversion rate, and surgery-related complications were compared between the groups. Results: Operation time and blood loss were affected by both surgical type and adhesion score. For cases with severe adhesions (adhesion score greater than 4), robotic surgery was associated with a shortened operation time (113.9 ± 38.4 min versus 164.3 ± 81.4 min, P = 0.007) and reduced blood loss (187.5 ± 148.7 mL versus 385.7 ± 482.6, P=0.044) compared with laparoscopy. Moreover, robotic group showed a lower postoperative pain score than laparoscopic group, as the effect was found to be independent of adhesion score or uterine weight. The grade-II complication rate was also found to be lower in the robotic group. Conclusions: Comparing to laparoscopic approach, robotic surgery is a feasible and potential alternative for performing total hysterectomy with severe adhesions.

Original languageEnglish
Pages (from-to)87-93
Number of pages7
JournalJournal of Minimal Access Surgery
Volume11
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

Fingerprint

Robotics
Hysterectomy
Laparoscopy
Uterus
Tissue Adhesions
Postoperative Pain
Length of Stay
Weights and Measures
Diet

Keywords

  • Pelvic adhesions
  • robotic surgery
  • total hysterectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Comparison of robotic surgery and laparoscopy to perform total hysterectomy with pelvic adhesions or large uterus. / Chiu, Li Hsuan; Chen, Ching Hui; Tu, Pei Chia; Chang, Ching Wen; Yen, Yuan Kuei; Liu, Wei-Min.

In: Journal of Minimal Access Surgery, Vol. 11, No. 1, 01.01.2015, p. 87-93.

Research output: Contribution to journalArticle

@article{e9c42ae6eced4f45807860f1cb0bfb2e,
title = "Comparison of robotic surgery and laparoscopy to perform total hysterectomy with pelvic adhesions or large uterus",
abstract = "Background: Currently, benefits of robotic surgery in patients with benign gynecological conditions remain unclear. In this study, we compared the surgical outcome of robotic and laparoscopic total hysterectomies and evaluated the feasibility of robotic surgery in cases with pelvic adhesions or large uterus. Materials and Methods: A total of 216 patients receiving total hysterectomy via robotic or laparoscopic approach were included in this study. Of all 216 patients, 88 underwent robotic total hysterectomy and 128 underwent laparoscopic total hysterectomy. All cases were grouped by surgical type, adhesion score, and uterine weight to evaluate the interaction or individual effect to the surgical outcomes. The perioperative parameters, including operation time, blood loss, postoperative pain score, time to full diet resumption, length of hospital stay, conversion rate, and surgery-related complications were compared between the groups. Results: Operation time and blood loss were affected by both surgical type and adhesion score. For cases with severe adhesions (adhesion score greater than 4), robotic surgery was associated with a shortened operation time (113.9 ± 38.4 min versus 164.3 ± 81.4 min, P = 0.007) and reduced blood loss (187.5 ± 148.7 mL versus 385.7 ± 482.6, P=0.044) compared with laparoscopy. Moreover, robotic group showed a lower postoperative pain score than laparoscopic group, as the effect was found to be independent of adhesion score or uterine weight. The grade-II complication rate was also found to be lower in the robotic group. Conclusions: Comparing to laparoscopic approach, robotic surgery is a feasible and potential alternative for performing total hysterectomy with severe adhesions.",
keywords = "Pelvic adhesions, robotic surgery, total hysterectomy",
author = "Chiu, {Li Hsuan} and Chen, {Ching Hui} and Tu, {Pei Chia} and Chang, {Ching Wen} and Yen, {Yuan Kuei} and Wei-Min Liu",
year = "2015",
month = "1",
day = "1",
doi = "10.4103/0972-9941.147718",
language = "English",
volume = "11",
pages = "87--93",
journal = "Journal of Minimal Access Surgery",
issn = "0972-9941",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "1",

}

TY - JOUR

T1 - Comparison of robotic surgery and laparoscopy to perform total hysterectomy with pelvic adhesions or large uterus

AU - Chiu, Li Hsuan

AU - Chen, Ching Hui

AU - Tu, Pei Chia

AU - Chang, Ching Wen

AU - Yen, Yuan Kuei

AU - Liu, Wei-Min

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background: Currently, benefits of robotic surgery in patients with benign gynecological conditions remain unclear. In this study, we compared the surgical outcome of robotic and laparoscopic total hysterectomies and evaluated the feasibility of robotic surgery in cases with pelvic adhesions or large uterus. Materials and Methods: A total of 216 patients receiving total hysterectomy via robotic or laparoscopic approach were included in this study. Of all 216 patients, 88 underwent robotic total hysterectomy and 128 underwent laparoscopic total hysterectomy. All cases were grouped by surgical type, adhesion score, and uterine weight to evaluate the interaction or individual effect to the surgical outcomes. The perioperative parameters, including operation time, blood loss, postoperative pain score, time to full diet resumption, length of hospital stay, conversion rate, and surgery-related complications were compared between the groups. Results: Operation time and blood loss were affected by both surgical type and adhesion score. For cases with severe adhesions (adhesion score greater than 4), robotic surgery was associated with a shortened operation time (113.9 ± 38.4 min versus 164.3 ± 81.4 min, P = 0.007) and reduced blood loss (187.5 ± 148.7 mL versus 385.7 ± 482.6, P=0.044) compared with laparoscopy. Moreover, robotic group showed a lower postoperative pain score than laparoscopic group, as the effect was found to be independent of adhesion score or uterine weight. The grade-II complication rate was also found to be lower in the robotic group. Conclusions: Comparing to laparoscopic approach, robotic surgery is a feasible and potential alternative for performing total hysterectomy with severe adhesions.

AB - Background: Currently, benefits of robotic surgery in patients with benign gynecological conditions remain unclear. In this study, we compared the surgical outcome of robotic and laparoscopic total hysterectomies and evaluated the feasibility of robotic surgery in cases with pelvic adhesions or large uterus. Materials and Methods: A total of 216 patients receiving total hysterectomy via robotic or laparoscopic approach were included in this study. Of all 216 patients, 88 underwent robotic total hysterectomy and 128 underwent laparoscopic total hysterectomy. All cases were grouped by surgical type, adhesion score, and uterine weight to evaluate the interaction or individual effect to the surgical outcomes. The perioperative parameters, including operation time, blood loss, postoperative pain score, time to full diet resumption, length of hospital stay, conversion rate, and surgery-related complications were compared between the groups. Results: Operation time and blood loss were affected by both surgical type and adhesion score. For cases with severe adhesions (adhesion score greater than 4), robotic surgery was associated with a shortened operation time (113.9 ± 38.4 min versus 164.3 ± 81.4 min, P = 0.007) and reduced blood loss (187.5 ± 148.7 mL versus 385.7 ± 482.6, P=0.044) compared with laparoscopy. Moreover, robotic group showed a lower postoperative pain score than laparoscopic group, as the effect was found to be independent of adhesion score or uterine weight. The grade-II complication rate was also found to be lower in the robotic group. Conclusions: Comparing to laparoscopic approach, robotic surgery is a feasible and potential alternative for performing total hysterectomy with severe adhesions.

KW - Pelvic adhesions

KW - robotic surgery

KW - total hysterectomy

UR - http://www.scopus.com/inward/record.url?scp=84920276133&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84920276133&partnerID=8YFLogxK

U2 - 10.4103/0972-9941.147718

DO - 10.4103/0972-9941.147718

M3 - Article

AN - SCOPUS:84920276133

VL - 11

SP - 87

EP - 93

JO - Journal of Minimal Access Surgery

JF - Journal of Minimal Access Surgery

SN - 0972-9941

IS - 1

ER -