Robotic vs Laparoscopic Hysterectomy: Is Robot Superior?

Abstract

The objective of this article is to reflect the current stand on robotic vs laparoscopic hysterectomy. There are only few recent studies comparing robotic with laparoscopic hysterectomy and most are retrospective. Early studies found prolonged operating times (e.g. 150.8 vs 114.4 minutes, p = 0.001) for robotic assisted than laparoscopic hysterectomy,1,2 but this appears to have been the result of a lack of experience with this new technology; the learning curve to reduce the robotic surgical time had median of 29 cases per surgeon.10 Subsequent studies reported operative durations which are comparable to conventional total laparoscopic hysterectomy, approximately 2 hours.13,14 A minority of studies have reported that roboticassisted is superior to conventional laparoscopic hysterectomy, with reports of shorter operative duration, decreased blood loss, decreased rate of conversion to laparotomy, decreased use of postoperative narcotic analgesia, and shorter hospital stay.1,2,12 Materials and methods: This involved the review of related articles to robotic vs laparoscopic hysterectomy. The scope of this review covered Medline, UpToDate, PubMed, Highwire press, Da Vinci community, Google search engine.12,13 Summary: Recent comparative studies have found that robotic and conventional laparoscopic hysterectomy are essentially equivalent regarding surgical and clinical outcome. Operating times are slightly higher and costs are significantly higher for the robotic hysterectomy.