Comparison of robotic and laparoscopic hysterectomy for benign gynecologic disease

摘要

The Rosero et al article has examined important inpatient data comparing outcomes in patients with benign disease undergoing robotic or laparo-scopic hysterectomy. It is important to note, however, that these data are from the national inpatient sample, and experience from high-volume centers has proven that many minimally invasive procedures performed robotically are performed through an outpatient approach. Patients undergoing minimally invasive surgery often are discharged either the same day or the next day. A recent 5-year comparison of quality metrics in patients with benign disease undergoing robotically assisted hysterectomy showed a decreased length of stay (LOS) and rate of readmissions before 30 days after surgery compared with nonrobotic cases. These findings differ from those of Rosero and those of Wright, whose recent article in JAMA reported no difference in quality outcomes. Differences between these studies most likely are related to volume, skills, and standardization of surgical pathways.