Robotic versus abdominal hysterectomy for very large uteri

Abstract

Background and Objectives: We sought to examine the outcomes of patients with myomatous uteri weighing >1000 g who underwent hysterectomy by one of two modalities, either with a robotic system or by laparotomy. Methods: All patients who underwent robotic hysterectomy for uteri weighing >1000 g at our institution between May 2007 and January 2011 were identified, and a retrospective chart review was performed. These patients were matched to a laparotomy control group by body mass index and uterine weight, and the postoperative outcomes in both groups were analyzed and compared. Results: Sixty patients with uteri weighing >1000 g underwent hysterectomy, 30 with the robotic system and 30 by laparotomy. The median body mass index was 31.8 kg/m2 (range, 18.5-56.3 kg/m2) and the median uterine weight was 1259 g (range, 1000-3543 g) in the robotic group versus 30.2 kg/m2 (range, 18-48 kg/m2) and 1509 g (range, 1000-3570 g), respectively, in the laparotomy group (P =.31). The median operating time was 255 minutes (range, 180-372 minutes) in the robotic group versus 150 minutes (range, 100-285 minutes) in the laparotomy group (P