Outcomes in women undergoing robotic‐assisted laparoscopic hysterectomy compared to conventional laparoscopic hysterectomy at a tertiary hospital in Western Australia

摘要

Background Robotic‐assisted laparoscopic hysterectomy ( RALH ) is associated with improved outcomes compared to open surgery in patients with endometrial cancer but data are conflicting when comparing RALH to conventional total laparoscopic hysterectomy ( TLH ). In October 2014, a RALH program was established in Perth, Western Australia. Aim To compare outcomes in patients undergoing RALH with a matched cohort undergoing TLH . Materials and methods A retrospective matched cohort study compared outcomes in 45 patients who underwent RALH with 45 controls who were patients treated with TLH . Results Mean operating time was longer in the RALH group compared to controls (75.42?min vs 53.18?min, mean difference 22.24?min, P ?0.001, 95% Cl, 11.07–33.42). No differences were observed in mean pain scores ( RALH 1.47 vs TLH 1.84 P? = ? 0.31), mean parenteral and oral opioid use ( RALH 14.3?mg and 42.4?mg vs TLH 17.5?mg and 52.57?mg, P? = 0.42 and 0.42, respectively), and mean length of stay ( RALH 1.51 vs TLH 1.67?days, P? = ? 0.49). Two patients in the RALH group and one patient in the TLH group sustained iatrogenic bladder injuries ( P ?=?0.62). Conclusion The establishment of the RALH program at our institution appeared to be associated with equivalent morbidity, post‐operative pain, opioid use and length of stay compared to conventional laparoscopy. A surgical learning curve for RALH was observed. Well‐designed prospective studies are needed to further evaluate short‐ and long‐term patient function, morbidity, quality of life and oncologic outcomes.