TY - JOUR
T1 - Comparison of robotic and laparoscopic hysterectomy for benign gynecologic disease
AU - Rosero, Eric B.
AU - Kho, Kimberly A.
AU - Joshi, Girish P.
AU - Giesecke, Martin
AU - Schaffer, Joseph I.
PY - 2013/10
Y1 - 2013/10
N2 - OBJECTIVE: Use of robotically assisted hysterectomy for benign gynecologic conditions is increasing. Using the most recent, available nationwide data, we examined clinical outcomes, safety, and cost of robotic compared with laparoscopic hysterectomy. METHODS: Women undergoing robotic or laparoscopic hysterectomy for benign disease were identified from the United States 2009 and 2010 Nationwide Inpatient Sample. Propensity scores derived from a logistic regression model were used to assemble matched cohorts of patients undergoing robotic and laparoscopic hysterectomy. Differences in in-hospital complications, hospital length of stay, and hospital charges were assessed between the matched groups. RESULTS: Of the 804,551 hysterectomies for benign conditions performed in 2009 and 2010, 20.6% were laparoscopic and 5.1% robotically assisted. Among minimally invasive hysterectomies, the use of robotic hysterectomy increased from 9.5% to 13.6% (P5.002). In a propensitymatched analysis, the overall complication rates were similar between robotic and laparoscopic hysterectomy (8.80% compared with 8.85%, relative risk 0.99, 95% confidence interval [CI] 0.89-1.09, P5.910). There was a lower incidence of blood transfusions in robotic cases (2.1% compared with 3.1%; P,.001), but patients undergoing robotic hysterectomy weremore likely to experience postoperative pneumonia (relative risk 2.2, 95% CI 1.24-3.78, P5.005). The median cost of hospital care was $9,788 (interquartile range $7,105-12,780) for robotic hysterectomy and $7,299 (interquartile range $5,650-9,583) for laparoscopic hysterectomy (P,.001). Hospital costs were on average $2,489 (95% CI $2,313-2,664) higher for patients undergoing robotic hysterectomy. CONCLUSION: The use of robotic hysterectomy has increased. Perioperative outcomes are similar between laparoscopic and robotic hysterectomy, but robotic cases cost substantially more.
AB - OBJECTIVE: Use of robotically assisted hysterectomy for benign gynecologic conditions is increasing. Using the most recent, available nationwide data, we examined clinical outcomes, safety, and cost of robotic compared with laparoscopic hysterectomy. METHODS: Women undergoing robotic or laparoscopic hysterectomy for benign disease were identified from the United States 2009 and 2010 Nationwide Inpatient Sample. Propensity scores derived from a logistic regression model were used to assemble matched cohorts of patients undergoing robotic and laparoscopic hysterectomy. Differences in in-hospital complications, hospital length of stay, and hospital charges were assessed between the matched groups. RESULTS: Of the 804,551 hysterectomies for benign conditions performed in 2009 and 2010, 20.6% were laparoscopic and 5.1% robotically assisted. Among minimally invasive hysterectomies, the use of robotic hysterectomy increased from 9.5% to 13.6% (P5.002). In a propensitymatched analysis, the overall complication rates were similar between robotic and laparoscopic hysterectomy (8.80% compared with 8.85%, relative risk 0.99, 95% confidence interval [CI] 0.89-1.09, P5.910). There was a lower incidence of blood transfusions in robotic cases (2.1% compared with 3.1%; P,.001), but patients undergoing robotic hysterectomy weremore likely to experience postoperative pneumonia (relative risk 2.2, 95% CI 1.24-3.78, P5.005). The median cost of hospital care was $9,788 (interquartile range $7,105-12,780) for robotic hysterectomy and $7,299 (interquartile range $5,650-9,583) for laparoscopic hysterectomy (P,.001). Hospital costs were on average $2,489 (95% CI $2,313-2,664) higher for patients undergoing robotic hysterectomy. CONCLUSION: The use of robotic hysterectomy has increased. Perioperative outcomes are similar between laparoscopic and robotic hysterectomy, but robotic cases cost substantially more.
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U2 - 10.1097/AOG.0b013e3182a4ee4d
DO - 10.1097/AOG.0b013e3182a4ee4d
M3 - Article
C2 - 24084534
AN - SCOPUS:84889831476
SN - 0029-7844
VL - 122
SP - 778
EP - 786
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 4
ER -