Three Port Robotic Hysterectomy Using Harmonic Scapel

Abstract

Study Objective: To evaluate the efficacy and safety of a three port robotic hysterectomy using Harmonic scalpel in women with indications for definitive surgical therapy. Design: Prospective study of 11 consecutive cases of Robotic Assisted Total Laparoscopic Hysterectomy with and without Bilateral Salpingo-Oophorectomy. Setting: Tertiary care hospital (Miami Valley Hospital); the first author involved in Minimally Invasive Surgery Fellowship program at Wright State University. Patients: Eleven women (ages 25-52) with surgical indications for hysterectomy. Intervention: All patients underwent a DaVinci robotic assisted Total laparoscopic Hysterectomy using only three access ports. A single surgeon with extensive laparoscopic proficiency but novice robotic skills performed all the procedures with Harmonic Scalpel. Measurements and Main Results: All eleven women completed the surgery and appropriate follow-up. The mean BMI was 28.59 (range 19.57-41.11). The mean pre and post Hemoglobin was 13.6 and 11.7 respectively. The mean blood loss was 66cc (range <20-150). Several time variables were measured as well. The mean time for the vaginal portion was 6.4 minutes (range 3-13). The mean time for trocar placement was 5.6 minutes (range 2-10). The mean docking time was 4.2 minutes (range 2-10). The mean console time was 53.4 minutes (range 33-91 minutes). The mean trocar to closure time was 73.3 minutes (range 49-119). The only complication was a missing intraperitoneal needle in one case which added several minutes to be retrieved.Tabled 1Surgical dataPatientBMIEBLVaginal (min)Trocar (min)Docking (min)Console (min)Tro-closure (min)123.41604326377225.115013234661336.9504634561425.52504284664522.6510031096995641.11504754189722.33509544566838.1715010734766927.412053833481032.37100494911151119.57508236175Mean28.5966.366.185.094.7253.3674.27 Open table in a new tab Conclusion: In our hands a three port robotic hysterectomy using Harmonic scalpel was a safe and efficient option for surgical intervention and a more acceptable cosmetic outcome for the patients.