Comparison of perioperative outcomes and cost between robotic-assisted and conventional laparoscopy for transperitoneal infrarenal para-aortic lymphadenectomy (TIPAL).
OBJECTIVE
To compare perioperative outcomes and cost of robotic-assisted and laparoscopic transperitoneal infrarenal para-aortic lymphadenectomy (TIPAL) for treatment of gynecologic malignant conditions.


METHODS
Prospective non-randomized study (Canadian Task Force classification II-2).


METHODS
Tertiary center for women's health.


METHODS
Sixty-two patients with gynecologic cancer operated on by the same surgical team.


METHODS
Thirty-two patients underwent TIPAL via robotic-assisted laparoscopy, and 30 via conventional laparoscopy. Comparison analyses of perioperative outcomes and estimated costs were performed.


RESULTS
There were no differences between robotic-assisted and laparoscopy insofar as age, body mass index, presurgical morbidity, operating time (92.5 minutes for robotics vs 96.6 minutes for laparoscopy), number of aortic nodes (12 vs. 12), hospitalization stay (2 vs. 2 days), or rate of complications (12.5% vs. 13.3%). Blood loss tended to be lower in the robotic group (75.0 vs. 92.5 mL; p = .08). Surgical cost was higher in the robotic group ($3.42 vs. $2.55; p < .001), although hospitalization cost was similar.


CONCLUSIONS
Robotic-assisted and laparoscopy provide similar perioperative outcomes. However, the robotic-assisted approach is associated with higher surgical cost.
Department of Obstetrics and Gynecology, Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain. Electronic address: pcoronadom@sego.es.
Pluvio J
PJ
Coronado
Service of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Madrid, Spain.
María
M
Fasero
Department of Gynecologic Surgery, Mayo Clinic Arizona, Scottsdale, Arizona.
Javier F
JF
Magrina
Department of Obstetrics and Gynecology, Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain.
Miguel A
MA
Herraiz
Department of Obstetrics and Gynecology, Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain.
José A
JA
Vidart
D000328:Adult; D000368:Aged; D001012:Aorta, Abdominal; D016063:Blood Loss, Surgical; D005260:Female; D017048:Health Care Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D008197:Lymph Node Excision / Q000191:economics / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000191:economics; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000191:economics / Q000379:methods*; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*
Cost; Infrarenal para-aortic lymphadenectomy; Laparoscopy; Perioperative outcomes; Robotic