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Risk factors for robotic gynecologic procedures requiring conversion to other surgical procedures
Author(s) -
Unger Cecile A.,
Lachiewicz Mark P.,
Ridgeway Beri
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2016.06.016
Subject(s) - medicine , laparotomy , perioperative , robotic surgery , odds ratio , confidence interval , surgery , retrospective cohort study , body mass index , incidence (geometry) , laparoscopy , general surgery , physics , optics
Objective To determine the incidence of, and risk factors for, conversion from robotic gynecologic procedures to other procedure types. Methods A retrospective cohort study included data from women who underwent any robotic gynecologic procedures between January 1, 2011 and December 31, 2012 at a tertiary care referral center in the USA. Demographic data, perioperative data, and surgeon experience (monthly case volume) data were retrieved; potential risk factors were compared between robotic procedures that were converted to other procedures and those completed as robotic procedures. Results There were 942 robotic procedures during the study period. Conversion from robotic to any other type of procedure was recorded for 47 (5.0%, 95% confidence interval 3.8–6.6) procedures and robotic‐to‐open‐surgery conversion occurred in 16 (1.7%, 95% confidence interval 1.0–2.7) procedures. Conversion from robotic surgery to another approach was associated with higher body mass index ( P < 0.001), previous laparotomy ( P = 0.042), and surgeons having a lower monthly robotic surgical case volume ( P = 0.011). Asthma ( P = 0.008), intra‐operative bowel injury ( P < 0.001), intra‐operative vascular injury ( P = 0.003), and single‐port robotic surgery ( P = 0.034) were associated with increased odds of requiring conversion from robotic procedures. Conclusion The overall incidence of conversion from robotic surgery to laparotomy was low. Higher body mass index, previous laparotomy, history of asthma, using a single‐port approach, and surgeon case volume were associated with the risk of conversion.