Operative Times of Robotic Hysterectomy Versus Other Modalities

Abstract

Study Objective Previous studies demonstrate that robotic surgeries have significantly longer operative times with minimal difference in outcomes. This argument has led to surgeons choosing other modalities over robotic surgery. However, these studies typically examine case operative times during a robotic surgeons’ training period. The aim of this study is to compare robotic hysterectomy data from an expert robotic surgeon to historical data of non-robotic hysterectomies. Design This study pools operative times from consecutive robotic hysterectomies performed by a surgeon who has been performing robotic hysterectomies for over ten years. The data was compared to the Premiere database. No postoperative follow-up data was reviewed for this study. Setting All patients had benign indications for hysterectomy. Patients or Participants Data was collected from 200 consecutive robotic cases. Cases were excluded if the primary surgery was not a hysterectomy and if operative times were not properly documented. Out of the 200 cases, 78 cases met criteria. These cases were compared to non-robotic hysterectomies from the Premier database, which included 289,875 cases. Interventions The primary surgery performed was a robotic hysterectomy. Measurements and Main Results The primary comparison was skin-to-skin operative time. Surgical complexity was accounted for by comparing primary surgery, number concomitant surgeries, concomitant surgery type, and resident involvement. Preliminary results show significantly faster operative times with the robot. The average robotic skin-to-skin operative time was 96 minutes; whereas, the average non-robotic skin-to-skin operative time was 130 minutes for vaginal, 147 minutes for abdominal, and 164 minutes for laparoscopic. Conclusion Our study demonstrates that an expert robotic surgeon's operative times were significantly faster to other modalities. With decreased operative times, demonstrated decreased estimated blood loss, and length of hospitalization with robotic surgeries, it is fair to suggest that robotic surgeries, if available, can be considered over other modalities given the associated benefits of robotic surgery.