Total Hysterectomy Robotic vs Laparoscopy

1. Total Hysterectomy Robotic vs Laparoscopy AlifahMdZizi,Wee W Sim , SuharjonoHaris, GaneshanMuniswaran Department of Obstetrics & Gynaecology Sarawak General Hospital Conclusions Objectives Although still being in its infancy, the evolution of robotic assisted surgeries has been dramatic. This study echoes the current notion that robotic surgeries are as superior if not more then conventional laparoscopic surgeries. The complications are rare and the learning curve is not as long as previously thought and this could prove to be the main advantage. Although the cost effectiveness of robotic surgeries still remains debatable, the ability of the robot to ensure more precise surgeries and in taking the surgeon’s fatigue out of the equation should ensure complicated procedures can be performed more safely. A revolution is on the way if cost is not a factor! Hysterectomy is the commonest gynecological surgery performed worldwide. Minimally invasive surgeries has revolutionized gynecological practice with positive implications on the patient and health system. Robotic assisted surgeries has overcome the shortcomings of laparoscopic surgeries and has shown great promise as the next evolution in surgical techniques. The objective of this study is to evaluate the outcome of robotic assisted total hysterectomies in comparison to the conventional total laparoscopic hysterectomy. Methods References This is a retrospective cohort study. All patients who had robotic assisted hysterectomy or conventional total laparoscopic hysterectomy in Sarawak General Hospital between 1st January 2009 till 31st January 2012 were included in this study. The patients were identified from the operating theater registry and the case notes were retrieved. Data were extracted systematically using a standardized profoma which included patient demography, indication, complications and outcome of surgeries. The results were analyzed using SPSS 17. • Reynolds RK, Advincula AP. Robot assisted laparoscopy hysterectomy: technique and initial experience. AM J Surg. 2006;191:555-560. • Stylopoulos N, Rattner D. Robotics and ergonomics. SurgClin North Am 2003:83:1321-27 • Anthony G, Visco MD, Arnold P, Advincula MD. Robotic Gynaecology Surgery. ObstetGynaecol 2008;112:1369-84. • Khaled SK. Robotic Assisted Laparoscopy Hysterectomy. Eastern Virginia Medical School, USA. • Dupont NC, Chandasekhar R, Wilding G, Guru KA. Current trends in robot assisted surgery: a survey of gynaecologic oncologists. Int J Med Robot 2010;6:468-72. • Bogges JF, Gehring AP, Cantrell I et al. Perioperative outcomes of robotically assisted hysterectomy for benign cases with complex pathology. ObstetGynaecol 2009;114:585-93 • Payne TN, Dauterive FR. A comparison of total laparoscopic hysterectomy to robotically assisted hysterectomy: surgical outcomes in a community practice. J Minimal Invasive Gynaecol 2008;15:286-9. • Shashoua AR, Gill D, Locher SR. Robotic assisted total laparoscopic hysterectomy versus conventional total laparoscopic hysterectomy. JSLS 2009;13:364-69. • Barnett JC, Judd JP, Wu JM et al. Cost comparison among robotic, laparoscopic and open hysterectomy for endometrial cancer. ACOG 2010;116 • Sarlos D, Kots L, Stevanovic N, Schaer G. Robotic hysterectomy versus conventional laparoscopic hysterectomy: outcome and cost analyses of matched case control study. Eur J ObstetGynaecolReprodBiol 2010;150:90-92 • Giep BN, Giep HN, Hubert HB. Comparison of minimally invasive surgical approaches for hysterectomy at a community hospital: robotic assisted laparoscopic hysterectomy, laparoscopic assisted vaginal hysterectomy. J Robot Surg 2010;4:167-175 • Fiorentino RP, Zepeda MA, Goldstein Bh, John CR. Pilot study assessing robotic laparoscopic hysterectomy and patient outcomes. J Mini Invasive Gynaecol. 2006;13:60-63 P 0.412 Results 22 patients had robotic assisted hysterectomy and 52 patients had conventional total laparoscopic hysterectomy during the study period.