title: Robotic-assisted laparoscopic myomectomy versus abdominal myomectomy: a comparative analysis of surgical outcomes and costs.
abstract: OBJECTIVE
  To compare clinical and effectiveness outcomes between robotic-assisted laparoscopic myomectomy (RALM) and abdominal myomectomy (AM).
  
  
  METHODS
  Records were reviewed for the first 27 RALM procedures at our institution. Age, BMI, insurance status, race, uterine size, and operative indication were used to select comparable patients who had undergone AM. Clinical and efficiency outcomes were compared stratifying for uterine size, specimen weight, and matched propensity scores.
  
  
  RESULTS
  IV hydromorphone use was significantly lower for RALM (P < 0.01), with no significant differences in blood loss or complications. RALM patients had significantly shorter hospital stays; however, total hospital charges were higher (P < 0.0001). This likely reflects longer operating room time (P < 0.0001), which was magnified as specimen size increased (P < 0.0001).
  
  
  CONCLUSIONS
  RALM patients require less IV hydromorphone, have shorter hospital stays, and have generally equivalent clinical outcomes compared with AM patients. Additionally, as specimen size increased, the operative efficiency of RALM decreased compared with AM.
authors.affiliation: Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Nash
authors.forename: Joe
authors.initials: J
authors.lastname: Feinglass
authors.forename: Charles
authors.initials: C
authors.lastname: Zei
authors.forename: Guanning
authors.initials: G
authors.lastname: Lu
authors.forename: Biftu
authors.initials: B
authors.lastname: Mengesha
authors.forename: Christina
authors.initials: C
authors.lastname: Lewicky-Gaupp
authors.forename: Alexander
authors.initials: A
authors.lastname: Lin
mesh_terms: D000005:Abdomen / Q000601:surgery; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D005260:Female; D017722:Hospital Charges; D006801:Humans; D004091:Hydromorphone / Q000008:administration & dosage; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics; D007889:Leiomyoma / Q000191:economics / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D016015:Logistic Models; D012189:Retrospective Studies; D012371:Robotics / Q000191:economics; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000191:economics / Q000473:pathology / Q000601:surgery*
chemical_list: D000701:Analgesics, Opioid; D004091:Hydromorphone