Robotic radical hysterectomy: comparison with laparoscopy and laparotomy.
OBJECTIVE
Comparison of perioperative results of patients undergoing radical hysterectomy by robotics, laparoscopy, and laparotomy.


METHODS
Prospective analysis of 27 patients undergoing robotic radical hysterectomy between April 2003 and September 2006. Comparison was made with patients operated by laparoscopy and laparotomy matched by age, BMI, site and type of malignancy, FIGO staging, and type of radical hysterectomy.


RESULTS
The mean operating times for patients undergoing robotic, laparoscopy and laparotomy radical hysterectomy were 189.6, 220.4, and 166.8 min, respectively; the mean blood loss was 133.1, 208.4, and 443.6 ml, respectively; the mean rate of blood loss was 0.7, 0.9, and 2.6 ml/min, respectively; the mean number of removed lymph nodes was 25.9, 25.9, and 27.7, respectively; and the mean length of hospital stay was 1.7, 2.4, and 3.6 days, respectively. There were no significant differences in intra- or postoperative complications among the three groups, no fistula formation in any patient and no conversions in the robotic or laparoscopic groups. At a mean follow up of 31.1 months, none of the patients with cervical cancer has experienced recurrence.


CONCLUSIONS
Laparoscopy and robotics are preferable to laparotomy for patients requiring radical hysterectomy. Operating times for robotics and laparotomy were similar, and significantly shorter as compared to laparoscopy. Blood loss, rate of blood loss and length of hospital stay were similar for laparoscopy and robotics and significantly reduced as compared to laparotomy.
Magrina
Javier F
JF
Division of Obstetrics and Gynecology, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, Arizona 85054, USA. jmagrina@mayo.edu
Kho
Rosanne M
RM
Weaver
Amy L
AL
Montero
Regina P
RP
Magtibay
Paul M
PM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012371:Robotics / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery