Robotic-Assisted Hysterectomy Reduces Hospital Readmission

Women undergoing robotic-assisted hysterectomy are significantly less likely to be readmitted to a hospital than women receiving laparoscopic, open, or vaginal hysterectomy, according to a new study.

Researchers at Lehigh Valley Health Network (Allentown, PA, USA) identified 2,554 women with benign disease who had undergone a hysterectomy between January 2008 and December 2012. The 2,554 women were grouped by route: robotic-assisted laparoscopic hysterectomy (601 women), laparoscopic hysterectomy (427), vaginal hysterectomy (332) and abdominal (1,194) hysterectomy. Based on clinical records, the 30-day readmission rates, estimated blood loss (EBL), overall lengths stay (LOS) in the hospital, and total readmission costs were determined for each of the four surgical methods.

The results showed that the readmission rates for robotic, vaginal, laparoscopic, and open were 1.0%, 2.4%, 2.5%, and 3.5%, respectively. EBL, LOS, and sum of cost were less in the robotic cohort compared to the other three cohorts. The reasons for readmission identified included fever or infection, wound complications, comorbidities, vaginal bleeding, uncontrolled pain, and bowel issues. The study was published online on October 21, 2013, in the Journal of Minimally Invasive Gynecology.

“Recently published comparative effective research in robotic surgery has compared the learned curve of laparoscopy to the learning curve of robotic-assisted surgery,” said lead author Martin Martino, MD. “Much of the benefit is due to the availability of 3-dimensional vision with improved dexterity. The purpose of our study was to remove that bias and evaluate quality outcomes after the learning curve for all patients having a hysterectomy for benign disease.”

Hysterectomy, or surgical removal of the uterus, is one of the most common surgical procedures for women in the United States. Approximately 600,000 hysterectomies are performed each year, primarily to address benign conditions such as noncancerous tumors, pelvic pain, and abnormal uterine bleeding.

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