Is robotic laparoscopic hysterectomy better than conventional laparoscopic hysterectomy?
With the growing popularity of robotic assisted laparoscopic procedures, researchers seek to find whether this procedure is an improvement over the traditional approach. A comparison was made by researchers from Kantonsspital Aarau (Aarau, Switzerland) and University Hospital Basel (Basel, Switzerland).
They published their findings in the September 2012 edition of the journal Obstetrics & Gynecology.
Traditionally, hysterectomies have been performed by open surgery, either via the abdominal or vaginal approach. Several decades ago, some gynecologic surgeons adopted the laparoscopic approach; however, most procedures continued to be done by the traditional approach.
A major breakthrough occurred in laparoscopy just before the turn of the century with the introduction of robotic surgery. The surgeon no longer had to hunch over the operating table; instead, he or she could sit at a console and view a magnified 3D image of internal structures by manipulating instruments that control robotic arms. Most gynecologic procedures can now be performed with the surgical robot, such as hysterectomies, myomectomies (removal of fibroid tumors on the uterus), removal of ovarian tumors, and even cancer surgeries. Current estimates are that 30-40% of all hysterectomies are now performed laparoscopically; furthermore, an ever-increasing number of surgeons are using the robot.
The researchers set out to compare surgical outcome and quality of life of robot-assisted laparoscopic hysterectomy with conventional laparoscopic hysterectomy. Patients with benign (non-cancerous) indications for hysterectomy were randomized to receive either a robotic (robotic group) or conventional laparoscopic hysterectomy (conventional group). The primary outcome measure was total operating time; the secondary outcome measures were perioperative outcome, blood loss, and the change in quality of life.