Objective To compare perioperative outcomes between robotic-assisted benign hysterectomies and abdominal, vaginal, and laparoscopic hysterectomies when performed by high-volume surgeons. Methods A multicenter data analysis compared 30-day outcomes from consecutive robotic-assisted hysterectomies performed by high-volume surgeons (≥ 60 prior procedures) at nine centers with records retrieved from the Premier Perspective database for abdominal, vaginal, and laparoscopic hysterectomies performed by high-volume gynecologic surgeons. Data on benign hysterectomy disorders from January 1, 2012 to September 30, 2013 were included. Results Data from 2300 robotic-assisted, 9745 abdominal, 8121 vaginal, and 11 952 laparoscopic hysterectomies were included. The robotic-assisted patient cohort had a significantly higher rate of adhesive disease compared with the vaginal (P < 0.001) and laparoscopic cohorts (P < 0.001), a significantly higher rate of morbid obesity than the vaginal (P < 0.001) or laparoscopic cohorts (P < 0.001), and a significantly higher rate of large uteri (> 250 g) than the abdominal (P < 0.001), vaginal (P < 0.001), or laparoscopic cohorts (P = 0.017). The robotic-assisted cohort experienced significantly fewer intraoperative complications than the abdominal (P < 0.001) and vaginal cohorts (P < 0.001), and experienced significantly fewer postoperative complications compared with all the comparator cohorts (P < 0.001). Conclusion When performed by gynecologic surgeons with relevant high-volume experience, robotic-assisted benign hysterectomy provided improved outcomes compared with abdominal, vaginal, and laparoscopic hysterectomy.
Lim, P. C., Crane, J. T., English, E. J., Farnam, R. W., Garza, D. M., Winter, M. L., & Rozeboom, J. L. (2016). Multicenter analysis comparing robotic, open, laparoscopic, and vaginal hysterectomies performed by high-volume surgeons for benign indications. International Journal of Gynecology and Obstetrics, 133(3), 359–364. https://doi.org/10.1016/j.ijgo.2015.11.010