Abstract
Objectives To demonstrate the initial experience of robotic hysterectomy to treat benign uterine disease at a university hospital in Brazil. Methods A cross-sectional study was conducted to review data from the first twenty patients undergoing robotic hysterectomy at our hospital. The surgeries were performed from November 2013 to August 2014, all of them by the same surgeon. The patients were reviewed for preoperative characteristics, including age, body mass index (BMI), indications for the hysterectomy and previous surgeries. Data of operative times, complications, postoperative pain and length of hospital stay were also collected. Results The total operating room time was 252.9 minutes, while the operative time was 180.7 minutes and the console time was 136.6 minutes. Docking time was 4.2 minutes, and the average undocking time was 1.9 minutes. There was a strong correlation between the operative time and the patient's BMI (r = 0.670; p = 0.001). The console time had significant correlation with the uterine weight and the patient's BMI (r = 0.468; p = 0.037). A learning curve was observed during docking and undocking times. Conclusion Despite its high cost, the robotic surgery is gaining more space in gynecological surgery. By the results obtained in our hospital, this surgical proposal proved to be feasible and safe. Our initial experience demonstrated a learning curve in some ways.
Highlights
Despite many non-surgical treatments for uterine conditions, hysterectomy is still a common surgical procedure
There was a strong correlation between the operative time and the patient’s body mass index (BMI) (r 1⁄4 0.670; p 1⁄4 0.001)
By the results obtained in our hospital, this surgical proposal proved to be feasible and safe
Summary
Despite many non-surgical treatments for uterine conditions, hysterectomy is still a common surgical procedure. It is estimated that 20–30% of women are to undergo this surgical procedure until they reach the age of 60.1,2 In the United States, hysterectomy is the second most performed gynecological surgery, preceded only by cesarean section.[3]. The frequency of this intervention varies in different countries, and it is higher in the United States and Australia when compared with Europe. The pathway choice is part of the surgical procedure, and several factors can influence the path of hysterectomy, including the size and shape of the vagina and uterus, accessibility, the presence of extra-uterine disease, needs for concomitant procedures, the training and experience of the surgeon, the technology available at the hospital, the resources, and even patient preference.[6]
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