AT THE AAGL GLOBAL CONGRESS
LAS VEGAS (FRONTLINE MEDICAL NEWS) – Robot-assisted laparoscopic hysterectomy is just as quick and safe as standard laparoscopic hysterectomy – at least in the hands of an experienced surgeon, according to a surgical trial of 144 women.
The first prospective, randomized trial comparing the two techniques found no differences in operative time, intraoperative complications, postoperative pain, length of stay, or 12-week complications, Dr. Timothy Deimling reported at a meeting sponsored by the AAGL.
He did caution, however, that the single surgeon who performed all of the procedures was highly experienced with robotic surgery, having performed more than 600 cases in his career.
The trial included 144 women who underwent hysterectomy for benign conditions. There were 72 women in each surgical group. They were consented at the time of consult, but not randomized until the morning of surgery, said Dr. Deimling of the Penn State Milton S. Hershey Medical Center, in Hershey, Pa.
There were no significant between-group differences in any of the baseline characteristics, nor in any of the indications for surgery, with one exception: More women in the laparoscopic group had undergone prior cesarean sections (44% vs. 23%).
The primary outcome was mean operative time, which was considered initial incision to closure. This was similar in the robot-assisted and laparoscopic groups (74 vs. 75 minutes).
Secondary outcomes were also similar, including pain, which was scored on a 1-10 scale. The mean score was 3.9 in the laparoscopic group and 3.8 in the robotic group. Likewise length of stay was similar (mean 19.6 vs. 22 hours).
There was one serious intraoperative complication. A patient in the laparoscopic group experienced a ureteral injury after the insertion of the first trocar, which resulted in termination of the surgery. She later had a successful laparoscopic hysterectomy. Postoperative complications were also similar in the two groups.
But it’s unclear if the results are generalizable. Dr. Deimling noted that the single surgeon who performed all the cases was highly experienced in robotic surgery. Additionally, all cases were assisted by a surgical team of nurses and technicians who were highly trained in both laparoscopic and robotic gynecologic surgery.
Dr. Deimling reported having no relevant financial disclosures.
