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Robotic radical hysterectomy: comparison of outcomes and cost
Operative and peri-operative outcomes, complications, and cost for radical hysterectomy for cervical cancer with negative sentinel nodes have been compared for robotics and laparotomy. Forty patients underwent radical hysterectomy with/out bilateral salpingo-oophorectomy, for early-stage cervical ca...
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| Published in: | Journal of robotic surgery 2010-12, Vol.4 (4), p.211-216 |
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| container_end_page | 216 |
| container_issue | 4 |
| container_start_page | 211 |
| container_title | Journal of robotic surgery |
| container_volume | 4 |
| creator | Halliday, Darron Lau, Susie Vaknin, Zvi Deland, Claire Levental, Mark McNamara, Elizabeth Gotlieb, Raphael Kaufer, Rebecca How, Jeffrey Cohen, Eva Gotlieb, Walter H. |
| description | Operative and peri-operative outcomes, complications, and cost for radical hysterectomy for cervical cancer with negative sentinel nodes have been compared for robotics and laparotomy. Forty patients underwent radical hysterectomy with/out bilateral salpingo-oophorectomy, for early-stage cervical cancer. All cases were performed by one of two surgeons, at a single institution (16 robotic, 24 laparotomy). The data for the robotic group were collected prospectively and compared with data for a historic cohort who underwent laparotomy. The data included demographics and peri-operative variables including operative time, estimated blood loss, lymph node count, hospital stay, and complications. Additionally, real direct hospital cost was compared for both modalities. Patients undergoing robotic radical hysterectomy experienced longer operative time than the laparotomy cohort (351 min vs. 283 min
P
= 0.0001). Estimated blood loss was significantly lower for the robotic cohort than for the laparotomy cohort (106 ml vs. 546 ml
P
|
| doi_str_mv | 10.1007/s11701-010-0205-z |
| format | article |
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P
= 0.0001). Estimated blood loss was significantly lower for the robotic cohort than for the laparotomy cohort (106 ml vs. 546 ml
P
< 0.0001). The minor complication rate was lower in the robotic cohort than for laparotomy (19% vs. 63%
P
= 0.003). Average hospital stay for the robotic patients was significantly shorter than for those undergoing laparotomy (1.9 days versus 7.2 days,
P
< 0.0001). Lymph node retrieval did not differ between the two groups (robotic 15 nodes, laparotomy 13 nodes). The total average peri-operative costs for radical hysterectomy with lymphadenectomy completed via laparotomy was CAN $11,764 ± 6,790, and for robotic assistance 8,183 ± 1,089 (
P
= 0.002). When amortization of the robot was included, there remained a trend in favor of the robotic approach, but it did not reach statistical significance. Whereas robotics takes longer to perform than traditional laparotomy, it provides the patient with a shorter hospital stay, less need for pain medications, and reduced peri-operative morbidity. In addition real average hospital costs tend to be lower.</description><identifier>ISSN: 1863-2483</identifier><identifier>EISSN: 1863-2491</identifier><identifier>DOI: 10.1007/s11701-010-0205-z</identifier><identifier>PMID: 27627947</identifier><language>eng</language><publisher>London: Springer-Verlag</publisher><subject>Blood ; Body mass index ; Cancer ; Cervical cancer ; Demographic variables ; Effectiveness ; Hospitals ; Hysterectomy ; Laparoscopy ; Laparotomy ; Lymphatic system ; Medicine ; Medicine & Public Health ; Minimally Invasive Surgery ; Oncology ; Original Article ; Patients ; Robotic surgery ; Robotics ; Surgeons ; Surgery ; Surgical outcomes ; Urology ; Uterus</subject><ispartof>Journal of robotic surgery, 2010-12, Vol.4 (4), p.211-216</ispartof><rights>Springer-Verlag London Ltd 2010</rights><rights>Springer-Verlag London Ltd 2010.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-1417c63086e396d9e0f121dd0097cd8634164e9ade867139f02b7cdbc2115633</citedby><cites>FETCH-LOGICAL-c372t-1417c63086e396d9e0f121dd0097cd8634164e9ade867139f02b7cdbc2115633</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27627947$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Halliday, Darron</creatorcontrib><creatorcontrib>Lau, Susie</creatorcontrib><creatorcontrib>Vaknin, Zvi</creatorcontrib><creatorcontrib>Deland, Claire</creatorcontrib><creatorcontrib>Levental, Mark</creatorcontrib><creatorcontrib>McNamara, Elizabeth</creatorcontrib><creatorcontrib>Gotlieb, Raphael</creatorcontrib><creatorcontrib>Kaufer, Rebecca</creatorcontrib><creatorcontrib>How, Jeffrey</creatorcontrib><creatorcontrib>Cohen, Eva</creatorcontrib><creatorcontrib>Gotlieb, Walter H.</creatorcontrib><title>Robotic radical hysterectomy: comparison of outcomes and cost</title><title>Journal of robotic surgery</title><addtitle>J Robotic Surg</addtitle><addtitle>J Robot Surg</addtitle><description>Operative and peri-operative outcomes, complications, and cost for radical hysterectomy for cervical cancer with negative sentinel nodes have been compared for robotics and laparotomy. Forty patients underwent radical hysterectomy with/out bilateral salpingo-oophorectomy, for early-stage cervical cancer. All cases were performed by one of two surgeons, at a single institution (16 robotic, 24 laparotomy). The data for the robotic group were collected prospectively and compared with data for a historic cohort who underwent laparotomy. The data included demographics and peri-operative variables including operative time, estimated blood loss, lymph node count, hospital stay, and complications. Additionally, real direct hospital cost was compared for both modalities. Patients undergoing robotic radical hysterectomy experienced longer operative time than the laparotomy cohort (351 min vs. 283 min
P
= 0.0001). Estimated blood loss was significantly lower for the robotic cohort than for the laparotomy cohort (106 ml vs. 546 ml
P
< 0.0001). The minor complication rate was lower in the robotic cohort than for laparotomy (19% vs. 63%
P
= 0.003). Average hospital stay for the robotic patients was significantly shorter than for those undergoing laparotomy (1.9 days versus 7.2 days,
P
< 0.0001). Lymph node retrieval did not differ between the two groups (robotic 15 nodes, laparotomy 13 nodes). The total average peri-operative costs for radical hysterectomy with lymphadenectomy completed via laparotomy was CAN $11,764 ± 6,790, and for robotic assistance 8,183 ± 1,089 (
P
= 0.002). When amortization of the robot was included, there remained a trend in favor of the robotic approach, but it did not reach statistical significance. Whereas robotics takes longer to perform than traditional laparotomy, it provides the patient with a shorter hospital stay, less need for pain medications, and reduced peri-operative morbidity. In addition real average hospital costs tend to be lower.</description><subject>Blood</subject><subject>Body mass index</subject><subject>Cancer</subject><subject>Cervical cancer</subject><subject>Demographic variables</subject><subject>Effectiveness</subject><subject>Hospitals</subject><subject>Hysterectomy</subject><subject>Laparoscopy</subject><subject>Laparotomy</subject><subject>Lymphatic system</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Minimally Invasive Surgery</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Robotic surgery</subject><subject>Robotics</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Urology</subject><subject>Uterus</subject><issn>1863-2483</issn><issn>1863-2491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNp1kE9LxDAQxYMo7rr6AbxIwYuXaiZpk0bwIIv_YEGQvYc0SbVL26xJe9j99GapriB4ypD3mzczD6FzwNeAMb8JABxDigGnmOA83R6gKRSMpiQTcLivCzpBJyGsMM55TuEYTQhnhIuMT9HdmytdX-vEK1Nr1SQfm9Bbb3Xv2s1tol27Vr4Orktclbihjx82JKozUQr9KTqqVBPs2fc7Q8vHh-X8OV28Pr3M7xepppz0KWTANaO4YJYKZoTFFRAwBmPBtYlLZsAyK5SxBeNARYVJGYVSE4CcUTpDV6Pt2rvPwYZetnXQtmlUZ90QJBTxekEF36GXf9CVG3wXl5NEQBHdOWeRgpHS3oXgbSXXvm6V30jAchetHKOVMVq5i1ZuY8_Ft_NQttbsO36yjAAZgRCl7t3639H_u34BVqeCcw</recordid><startdate>20101201</startdate><enddate>20101201</enddate><creator>Halliday, Darron</creator><creator>Lau, Susie</creator><creator>Vaknin, Zvi</creator><creator>Deland, Claire</creator><creator>Levental, Mark</creator><creator>McNamara, Elizabeth</creator><creator>Gotlieb, Raphael</creator><creator>Kaufer, Rebecca</creator><creator>How, Jeffrey</creator><creator>Cohen, Eva</creator><creator>Gotlieb, Walter H.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>L6V</scope><scope>M0S</scope><scope>M7S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>7X8</scope></search><sort><creationdate>20101201</creationdate><title>Robotic radical hysterectomy: comparison of outcomes and cost</title><author>Halliday, Darron ; Lau, Susie ; Vaknin, Zvi ; Deland, Claire ; Levental, Mark ; McNamara, Elizabeth ; Gotlieb, Raphael ; Kaufer, Rebecca ; How, Jeffrey ; Cohen, Eva ; Gotlieb, Walter H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-1417c63086e396d9e0f121dd0097cd8634164e9ade867139f02b7cdbc2115633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Blood</topic><topic>Body mass index</topic><topic>Cancer</topic><topic>Cervical cancer</topic><topic>Demographic variables</topic><topic>Effectiveness</topic><topic>Hospitals</topic><topic>Hysterectomy</topic><topic>Laparoscopy</topic><topic>Laparotomy</topic><topic>Lymphatic system</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Minimally Invasive Surgery</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Robotic surgery</topic><topic>Robotics</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Urology</topic><topic>Uterus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Halliday, Darron</creatorcontrib><creatorcontrib>Lau, Susie</creatorcontrib><creatorcontrib>Vaknin, Zvi</creatorcontrib><creatorcontrib>Deland, Claire</creatorcontrib><creatorcontrib>Levental, Mark</creatorcontrib><creatorcontrib>McNamara, Elizabeth</creatorcontrib><creatorcontrib>Gotlieb, Raphael</creatorcontrib><creatorcontrib>Kaufer, Rebecca</creatorcontrib><creatorcontrib>How, Jeffrey</creatorcontrib><creatorcontrib>Cohen, Eva</creatorcontrib><creatorcontrib>Gotlieb, Walter H.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Engineering Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Engineering Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of robotic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Halliday, Darron</au><au>Lau, Susie</au><au>Vaknin, Zvi</au><au>Deland, Claire</au><au>Levental, Mark</au><au>McNamara, Elizabeth</au><au>Gotlieb, Raphael</au><au>Kaufer, Rebecca</au><au>How, Jeffrey</au><au>Cohen, Eva</au><au>Gotlieb, Walter H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic radical hysterectomy: comparison of outcomes and cost</atitle><jtitle>Journal of robotic surgery</jtitle><stitle>J Robotic Surg</stitle><addtitle>J Robot Surg</addtitle><date>2010-12-01</date><risdate>2010</risdate><volume>4</volume><issue>4</issue><spage>211</spage><epage>216</epage><pages>211-216</pages><issn>1863-2483</issn><eissn>1863-2491</eissn><abstract>Operative and peri-operative outcomes, complications, and cost for radical hysterectomy for cervical cancer with negative sentinel nodes have been compared for robotics and laparotomy. Forty patients underwent radical hysterectomy with/out bilateral salpingo-oophorectomy, for early-stage cervical cancer. All cases were performed by one of two surgeons, at a single institution (16 robotic, 24 laparotomy). The data for the robotic group were collected prospectively and compared with data for a historic cohort who underwent laparotomy. The data included demographics and peri-operative variables including operative time, estimated blood loss, lymph node count, hospital stay, and complications. Additionally, real direct hospital cost was compared for both modalities. Patients undergoing robotic radical hysterectomy experienced longer operative time than the laparotomy cohort (351 min vs. 283 min
P
= 0.0001). Estimated blood loss was significantly lower for the robotic cohort than for the laparotomy cohort (106 ml vs. 546 ml
P
< 0.0001). The minor complication rate was lower in the robotic cohort than for laparotomy (19% vs. 63%
P
= 0.003). Average hospital stay for the robotic patients was significantly shorter than for those undergoing laparotomy (1.9 days versus 7.2 days,
P
< 0.0001). Lymph node retrieval did not differ between the two groups (robotic 15 nodes, laparotomy 13 nodes). The total average peri-operative costs for radical hysterectomy with lymphadenectomy completed via laparotomy was CAN $11,764 ± 6,790, and for robotic assistance 8,183 ± 1,089 (
P
= 0.002). When amortization of the robot was included, there remained a trend in favor of the robotic approach, but it did not reach statistical significance. Whereas robotics takes longer to perform than traditional laparotomy, it provides the patient with a shorter hospital stay, less need for pain medications, and reduced peri-operative morbidity. In addition real average hospital costs tend to be lower.</abstract><cop>London</cop><pub>Springer-Verlag</pub><pmid>27627947</pmid><doi>10.1007/s11701-010-0205-z</doi><tpages>6</tpages></addata></record> |
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| subjects | Blood Body mass index Cancer Cervical cancer Demographic variables Effectiveness Hospitals Hysterectomy Laparoscopy Laparotomy Lymphatic system Medicine Medicine & Public Health Minimally Invasive Surgery Oncology Original Article Patients Robotic surgery Robotics Surgeons Surgery Surgical outcomes Urology Uterus |
| title | Robotic radical hysterectomy: comparison of outcomes and cost |
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