Descriptive study using a survey (Canadian Task Force classification III).
Single-specialty referral-based gynecology practice.
All patients older than 18 years who came for care to the Newton-Wellesley Hospital Minimally Invasive Gynecological Surgery Center from April 2, 2010, to June 30, 2010.
Three identical photos of an unscarred female abdomen were each marked with a black pen to indicate typical incision lengths and locations for robotic, single-site, and traditional laparoscopic surgery. Subjects were then asked to rank these incisions in order of preference. Additional demographic and surgical history questions were included in the survey.
Two-hundred fifty of 427 patients (58.5 % ) returned surveys, and of these, 241 completed critical survey elements. Preference for traditional laparoscopic incisions was 56.4 % (95 % confidence interval [CI], 50.1 % -62.7 % ), for a single incision was 41.1 % (95 % CI, 34.8 % -47.3 % ), and for robotic surgery was 2.5 % (95 % CI, 0.5 % -4.5 % ). Two-sample test of proportion (Z test) showed the difference in preference for traditional over the other methods to be significant: p = .007 for a single incision and p <.001 for robotic surgery. Multivariatble analysis for factors influencing choice of single-site incision demonstrated that Latina/Hispanic ethnicity was the only significant factor (p = .02).
Women prefer both single-site and traditional laparoscopic incisions over robotic procedures. Inasmuch as aesthetics are an important consideration for many women and clinical outcomes are similar, during the informed-consent procedure, location and length of incisions should be included in the discussion of risks, benefits, and alternatives.