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Outcomes in women undergoing robotic‐assisted laparoscopic hysterectomy compared to conventional laparoscopic hysterectomy at a tertiary hospital in Western Australia
Author(s) -
Rajadurai Vinita A.,
Tan Jason,
Salfinger Stuart G.,
Cohen Paul A.
Publication year - 2018
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12749
Subject(s) - medicine , hysterectomy , retrospective cohort study , laparoscopy , surgery , pelvic pain , cohort , laparoscopic hysterectomy , prospective cohort study
Background Robotic‐assisted laparoscopic hysterectomy ( RALH ) is associated with improved outcomes compared to open surgery in patients with endometrial cancer but data are conflicting when comparing RALH to conventional total laparoscopic hysterectomy ( TLH ). In October 2014, a RALH program was established in Perth, Western Australia. Aim To compare outcomes in patients undergoing RALH with a matched cohort undergoing TLH . Materials and methods A retrospective matched cohort study compared outcomes in 45 patients who underwent RALH with 45 controls who were patients treated with TLH . Results Mean operating time was longer in the RALH group compared to controls (75.42 min vs 53.18 min, mean difference 22.24 min, P < 0.001, 95% Cl, 11.07–33.42). No differences were observed in mean pain scores ( RALH 1.47 vs TLH 1.84 P = 0.31), mean parenteral and oral opioid use ( RALH 14.3 mg and 42.4 mg vs TLH 17.5 mg and 52.57 mg, P = 0.42 and 0.42, respectively), and mean length of stay ( RALH 1.51 vs TLH 1.67 days, P = 0.49). Two patients in the RALH group and one patient in the TLH group sustained iatrogenic bladder injuries ( P = 0.62). Conclusion The establishment of the RALH program at our institution appeared to be associated with equivalent morbidity, post‐operative pain, opioid use and length of stay compared to conventional laparoscopy. A surgical learning curve for RALH was observed. Well‐designed prospective studies are needed to further evaluate short‐ and long‐term patient function, morbidity, quality of life and oncologic outcomes.