Longer OR Times Confirmed in Robotic Hysterectomy

HOLLYWOOD, FLA. – Robotic-assisted hysterectomy takes significantly more operating room time and surgical time compared with a laparoscopic approach, according to the first randomized controlled trial to confirm what many already suspect about these two minimally invasive techniques.

Uterine weight, hospital length of stay, and rates of short- or long-term complications, in contrast, did not significantly differ between the 26 women randomized to robotic-assisted total laparoscopic hysterectomy and the 27 randomized to total laparoscopic hysterectomy. In addition, researchers found no significant differences between pain scores or the mean time for these women to return to activities.

“Robotic assistance results in longer OR times,” Dr. Marie Fidela Paraiso said at the meeting.

Operative time was the main outcome of the study. Mean time in the operating room was 246 minutes in the robotic group versus 172 minutes in the laparoscopic patients. Mean case time, or time from incision to closure of the hysterectomy, was 173 minutes in the robotic group versus 103 minutes in the laparoscopy group.

“There were no differences in intraoperative or postoperative complications between groups,” Dr. Paraiso said. Similarly, estimated blood loss and postoperative hematocrit findings did not differ significantly between groups. Follow-up was at 6 weeks and 6 months.

Although there were no differences in length of stay by surgical approach, patients whose surgeries lasted more than 185 minutes had a significantly longer hospital stay than did patients with shorter surgeries, said Dr. Paraiso, head of the Center for Urogynecology and Reconstructive Pelvic Surgery and staff physician in the department of obstetrics and gynecology at the Cleveland Clinic.

Dr. Paraiso and her colleagues also assessed functional status and quality of life using the Short Form −36 and pain using visual analog scales at baseline and postoperatively. “There were no differences in pain between groups on postoperative visual analog scales.”

She also assessed the economics of the robotic-assisted versus laparoscopic cases in the study, but the data were still being analyzed at press time.

The randomized clinical trial design and inclusion of hospital parameters were strengths of the study, Dr. Paraiso said. “There are currently no randomized controlled trials in the gynecologic literature comparing robotic versus conventional hysterectomy.”

Limitations included the small number of participants, a limited follow-up time, and a question about the generalizability of the findings to other institutions, she said.

The study included adult women who had hysterectomy for a benign indication and who desired laparoscopic management. Mean age was 45 years and mean body mass index was 31 kg/m

HOLLYWOOD, FLA. – Robotic-assisted hysterectomy takes significantly more operating room time and surgical time compared with a laparoscopic approach, according to the first randomized controlled trial to confirm what many already suspect about these two minimally invasive techniques.

Uterine weight, hospital length of stay, and rates of short- or long-term complications, in contrast, did not significantly differ between the 26 women randomized to robotic-assisted total laparoscopic hysterectomy and the 27 randomized to total laparoscopic hysterectomy. In addition, researchers found no significant differences between pain scores or the mean time for these women to return to activities.

“Robotic assistance results in longer OR times,” Dr. Marie Fidela Paraiso said at the meeting.

Operative time was the main outcome of the study. Mean time in the operating room was 246 minutes in the robotic group versus 172 minutes in the laparoscopic patients. Mean case time, or time from incision to closure of the hysterectomy, was 173 minutes in the robotic group versus 103 minutes in the laparoscopy group.

“There were no differences in intraoperative or postoperative complications between groups,” Dr. Paraiso said. Similarly, estimated blood loss and postoperative hematocrit findings did not differ significantly between groups. Follow-up was at 6 weeks and 6 months.

Although there were no differences in length of stay by surgical approach, patients whose surgeries lasted more than 185 minutes had a significantly longer hospital stay than did patients with shorter surgeries, said Dr. Paraiso, head of the Center for Urogynecology and Reconstructive Pelvic Surgery and staff physician in the department of obstetrics and gynecology at the Cleveland Clinic.

Dr. Paraiso and her colleagues also assessed functional status and quality of life using the Short Form −36 and pain using visual analog scales at baseline and postoperatively. “There were no differences in pain between groups on postoperative visual analog scales.”

She also assessed the economics of the robotic-assisted versus laparoscopic cases in the study, but the data were still being analyzed at press time.

The randomized clinical trial design and inclusion of hospital parameters were strengths of the study, Dr. Paraiso said. “There are currently no randomized controlled trials in the gynecologic literature comparing robotic versus conventional hysterectomy.”

Limitations included the small number of participants, a limited follow-up time, and a question about the generalizability of the findings to other institutions, she said.

The study included adult women who had hysterectomy for a benign indication and who desired laparoscopic management. Mean age was 45 years and mean body mass index was 31 kg/m

HOLLYWOOD, FLA. – Robotic-assisted hysterectomy takes significantly more operating room time and surgical time compared with a laparoscopic approach, according to the first randomized controlled trial to confirm what many already suspect about these two minimally invasive techniques.

Uterine weight, hospital length of stay, and rates of short- or long-term complications, in contrast, did not significantly differ between the 26 women randomized to robotic-assisted total laparoscopic hysterectomy and the 27 randomized to total laparoscopic hysterectomy. In addition, researchers found no significant differences between pain scores or the mean time for these women to return to activities.

“Robotic assistance results in longer OR times,” Dr. Marie Fidela Paraiso said at the meeting.

Operative time was the main outcome of the study. Mean time in the operating room was 246 minutes in the robotic group versus 172 minutes in the laparoscopic patients. Mean case time, or time from incision to closure of the hysterectomy, was 173 minutes in the robotic group versus 103 minutes in the laparoscopy group.

“There were no differences in intraoperative or postoperative complications between groups,” Dr. Paraiso said. Similarly, estimated blood loss and postoperative hematocrit findings did not differ significantly between groups. Follow-up was at 6 weeks and 6 months.

Although there were no differences in length of stay by surgical approach, patients whose surgeries lasted more than 185 minutes had a significantly longer hospital stay than did patients with shorter surgeries, said Dr. Paraiso, head of the Center for Urogynecology and Reconstructive Pelvic Surgery and staff physician in the department of obstetrics and gynecology at the Cleveland Clinic.

Dr. Paraiso and her colleagues also assessed functional status and quality of life using the Short Form −36 and pain using visual analog scales at baseline and postoperatively. “There were no differences in pain between groups on postoperative visual analog scales.”

She also assessed the economics of the robotic-assisted versus laparoscopic cases in the study, but the data were still being analyzed at press time.

The randomized clinical trial design and inclusion of hospital parameters were strengths of the study, Dr. Paraiso said. “There are currently no randomized controlled trials in the gynecologic literature comparing robotic versus conventional hysterectomy.”

Limitations included the small number of participants, a limited follow-up time, and a question about the generalizability of the findings to other institutions, she said.

The study included adult women who had hysterectomy for a benign indication and who desired laparoscopic management. Mean age was 45 years and mean body mass index was 31 kg/m