Single-site Versus Multiport Robotic Hysterectomy in Benign Gynecologic Diseases: A Retrospective Evaluation of Surgical Outcomes and Cost Analysis

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• 作者：Stefano Bogliolo ; MD<sup>asup><sup> ; sup><sup>s.bogliolo@smatteo.pv.it" class="auth_mail" title="E-mail the corresponding authorsup> ; Simone Ferrero ; MD ; PhD<sup>bsup><sup> ; sup><sup>csup> ; Chiara Cassani ; MD<sup>asup> ; Valentina Musacchi ; MD<sup>asup> ; Francesca Zanellini ; MD<sup>asup> ; Mattia Dominoni ; MD<sup>asup> ; Arsenio Spinillo ; MD<sup>asup> ; Barbara Gardella ; MD<sup>asup>
• 关键词：Complications ; Costs ; Robotic-assisted laparoscopy ; Robotic hysterectomy ; Single-port robotic hysterectomy ; Single-site robotic hysterectomy
• 刊名：Journal of Minimally Invasive Gynecology
• 出版年：2016
• 出版时间：May-June 2016
• 年：2016
• 卷：23
• 期：4
• 页码：603-609
• 全文大小：549 K

文摘

To compare the surgical outcomes and costs of robotic-assisted hysterectomy with the single-site (RSSH) or multiport approach (RH).

sSec_2">Design

spara0015">A retrospective analysis of a prospectively collected database (Canadian Task Force classification II1).

sSec_3">Setting

spara0020">A university hospital.

sSec_4">Patients

spara0025">Consecutive women who underwent robotic-assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for the treatment of benign gynecologic diseases.

sSec_5">Interventions

spara0030">Data on surgical approach, surgical outcomes, and costs were collected in a prospective database and retrospectively analyzed.

sSec_6">Measurements and Main Results

spara0035">The total operative time, console time, docking time, estimated blood loss, conversion rate, and surgical complications rate were compared between the 2 study groups. Cost analysis was performed. One hundred four patients underwent total robotic-assisted hysterectomy and bilateral salpingo-oophorectomy (45 RSSH and 59 RH). There was no significant difference in the indications for surgery and in the characteristics of the patients between the 2 study groups. There was no significant difference between the single-site and multiport approach in console time, surgical complication rate, conversion rate, and postoperative pain. The docking time was lower in the RH group (p = .0001). The estimated blood loss and length of hospitalization were lower in the RSSH group (p = .0008 and p = .009, respectively). The cost analysis showed significant differences in favor of RSSH.

sSec_7">Conclusion

spara0040">RSSH should be preferred to RH when hysterectomy is performed for benign disease because it could be at least as equally effective and safe with a potential cost reduction. However, because of the high cost and absence of clear advantages, the robotic approach should be considered only for selected patients.