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Robotic hysterectomy

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https://www.readbyqxmd.com/read/28430728/the-impact-of-a-dedicated-robotic-team-on-robotic-assisted-sacrocolpopexy-outcomes
#1
Charelle M Carter-Brooks, Angela L Du, Michael J Bonidie, Jonathan P Shepherd
BACKGROUND: Robotic-assisted sacrocolpopexy has been criticized for high cost. A strategy to increase operating room efficiency and decrease cost is implementation of a dedicated robotic team. Our objective was to determine if a dedicated robotic team decreases operative time. STUDY DESIGN: This institutional review board-approved retrospective cohort study included all robotic-assisted sacrocolpopexy performed from June 2010 to August 2015 by a single surgeon at 2 institutions in 1 health system...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28430689/perioperative-outcomes-of-robotic-assisted-hysterectomy-compared-with-open-hysterectomy
#2
Bhargavi Gali, Jamie N Bakkum-Gamez, David J Plevak, Darrell Schroeder, Timothy O Wilson, Christopher J Jankowski
BACKGROUND: Increasing numbers of robotic hysterectomies (RH) are being performed. To provide ventilation (with pneumoperitoneum and steep Trendelenburg position) for these procedures, utilization of lung protective strategies with limiting airway pressures and tidal volumes is difficult. Little is known about the effects of intraoperative mechanical ventilation and high peak airway pressures on perioperative complications. We performed a retrospective review to determine whether patients undergoing RH had increased pulmonary complications compared to total abdominal hysterectomy (TAH)...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28429948/-robotic-surgery-in-gynecology
#3
R Pilka
INTRODUCTION: The aim of this review is to provide a general historical and contemporary perspective on the implementation and use of robot-assisted laparoscopy in gynecology as well as the experience gained to date. CONTENTS: Robotic-assisted laparoscopic surgeries in gynecology include benign hysterectomy, myomectomy, radical hysterectomy, lymph node dissections or sacrocolpopexies. Robot-assisted gynecologic surgery is often associated with longer operating room time but generally similar clinical outcomes, decreased blood loss and shorter hospital stay when compared to open or laparoscopic surgery...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28429119/single-port-hysterectomy-robotic-versus-laparoscopic
#4
Mete Gungor, Korhan Kahraman, Polat Dursun, Esra Ozbasli, Canan Genim
This study evaluated the feasibility and safety of robotic single port hysterectomy and laparoscopic single port hysterectomy, and to compare the perioperative parameters of the two systems. Twenty patients underwent robotic single port hysterectomy and 25 patients underwent laparoscopic single port hysterectomy. All hysterectomies were successfully performed via a single port and there were no conversions to conventional multi-port laparoscopy, multi-port robotic, open surgery, or vaginal surgery. The median operative time and hysterectomy time in robotic and laparoscopic groups were 90 vs...
April 20, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28403973/a-national-snapshot-of-the-surgical-management-of-deep-infiltrating-endometriosis-of-the-rectum-and-colon-in-france-in-2015-a-multicenter-series-of-1135-cases
#5
H Roman
OBJECTIVE: To perform a survey on the characteristics of the surgical management of patients with deep infiltrating endometriosis of the rectum and the sigmoid colon (DIERS) in France in 2015. METHOD: Case-series study enrolling patients with DIERS involving muscularis, submucosa or mucosa, operated on from January 1st to December 31st 2015, in 56 healthcare facilities in France. Surgeons filled in questionnaires concerning the number of patients, deep endometriosis localizations, surgical route and techniques used on digestive tract, associated surgical procedures and major complications...
February 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28400697/the-impact-of-individual-surgeon-volume-on-hysterectomy-costs
#6
Jonathan P Shepherd, Charelle M Carter-Brooks, Kelly L Kantartzis, Ted Lee, Michael J Bonidie
BACKGROUND AND OBJECTIVE: Hysterectomy is one of the most common surgical procedures women will undergo in their lifetime. Several factors affect surgical outcomes. It has been suggested that high-volume surgeons favorably affect outcomes and hospital cost. The objective is to determine the impact of individual surgeon volume on total hospital costs for hysterectomy. METHODS: This is a retrospective cohort of women undergoing hysterectomy for benign indications from 2011 to 2013 at 10 hospitals within the University of Pittsburgh Medical Center System...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28392125/vaginal-vs-robotic-hysterectomy-for-patients-with-endometrial-cancer-a-comparison-of-outcomes-and-cost-of-care
#7
C C Nitschmann, F Multinu, J N Bakkum-Gamez, C L Langstraat, J A Occhino, A L Weaver, W A Cliby, A Mariani, S C Dowdy
OBJECTIVE: To compare outcomes and cost for patients with endometrial cancer undergoing vaginal hysterectomy (VH) or robotic hysterectomy (RH), with or without lymphadenectomy (LND). METHODS: Patients undergoing planned VH (and laparoscopic LND) or RH (and robotic LND) between January 2007 and November 2012 were reviewed. Patients with stage IV disease, synchronous cancer, synchronous surgery, or treated with palliative intent were excluded. Patients were objectively triaged to LND per institutional protocol based on frozen section...
April 6, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28383369/geographic-variance-of-cost-associated-with-hysterectomy
#8
David Sheyn, Sangeeta Mahajan, Megan Billow, Alexandra Fleary, Emi Hayashi, Sherif A El-Nashar
OBJECTIVE: To estimate whether the cost of hysterectomy varies by geographic region. METHODS: This was a cross-sectional, population-based study using the 2013 Healthcare Cost and Utilization Project National Inpatient Sample of women older than 18 years undergoing inpatient hysterectomy for benign conditions. Hospital charges obtained from the National Inpatient Sample database were converted to actual costs using cost-to-charge ratios provided by the Healthcare Cost and Utilization Project...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28373977/learning-curve-analysis-of-different-stages-of-robotic-assisted-laparoscopic-hysterectomy
#9
Feng-Hsiang Tang, Eing-Mei Tsai
Objective. To analyze the learning curves of the different stages of robotic-assisted laparoscopic hysterectomy. Design. Retrospective analysis. Design Classification. Canadian Task Force classification II-2. Setting. Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Patient Intervention. Women receiving robotic-assisted total and subtotal laparoscopic hysterectomies for benign conditions from May 1, 2013, to August 31, 2015. Measurements and Main Results. The mean age, body mass index (BMI), and uterine weight were 46...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28363438/reducing-surgical-site-infections-after-hysterectomy-metronidazole-plus-cefazolin-compared-with-cephalosporin%C3%A2-alone
#10
Sara R Till, Daniel M Morgan, Ali A Bazzi, Mark D Pearlman, Zaid Abdelsattar, Darrell A Campbell, Shitanshu Uppal
BACKGROUND: Organisms that are isolated from vaginal cuff infections and pelvic abscesses after hysterectomy frequently include anaerobic vaginal flora. Metronidazole has outstanding coverage against nearly all anaerobic species, which is superior to both cefazolin and second-generation cephalosporins. Cefazolin plus metronidazole has been demonstrated to reduce infectious morbidity compared with either cefazolin or second-generation cephalosporins in other clean-contaminated procedures, which include both as colorectal surgery and cesarean delivery...
March 28, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28356774/robotic-assisted-hysterectomy-patient-selection-and-perspectives
#11
Noam Smorgick
Minimally invasive hysterectomy via the laparoscopic or vaginal approach is beneficial to patients when compared with laparotomy, but has not been offered in the past to all women because of the technical difficulties and the long learning curve required for laparoscopic hysterectomy. Robotic-assisted hysterectomy for benign indications may allow for a shorter learning curve but does not offer clear advantages over conventional laparoscopic hysterectomy in terms of surgical outcomes. In addition, robotic hysterectomy is invariably associated with increased costs...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28353196/robotic-assisted-vesicovaginal-fistula-repair-using-an-extravesical-approach-without-interposition-grafting
#12
Erin Kelly, Maria Y Wu, J Barry MacMillan
BACKGROUND: Post-hysterectomy vesicovaginal fistula (VVF) is rare. In addition to conventional abdominal and vaginal approaches, robotic-assisted VVF repairs have recently been described. We present a case of an extravesical, robotic-assisted VVF repair, without placement of an interposition graft performed in a Canadian teaching center. CASE: A 51-year-old woman presented with urinary incontinence 5 days after laparoscopic hysterectomy. Computed tomography cystogram, cystoscopy, and methylene blue dye test, confirmed a VVF above the bladder trigone...
March 28, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28352147/minimally-invasive-hysterectomy-for-uteri-greater-than-one-kilogram
#13
Traci E Ito, Maria V Vargas, Gaby N Moawad, Jessica Opoku-Anane, Michael K M Shu, Cherie Q Marfori, James K Robinson
BACKGROUND AND OBJECTIVES: To assess the feasibility and safety of minimally invasive hysterectomy for uteri >1 kg. METHODS: Clinical and surgical characteristics were collected for patients in an academic tertiary care hospital. Included were patients who underwent minimally invasive hysterectomy by 1 of 3 fellowship-trained gynecologists from January 1, 2009, to July 1, 2015 and subsequently had confirmed uterine weights of 1 kg or greater on pathology report...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28352146/power-morcellation-using-a-contained-bag-system
#14
Courtney Steller, Aarathi Cholkeri-Singh, Kirsten Sasaki, Charles E Miller
BACKGROUND AND OBJECTIVES: The well-known advantages of minimally invasive surgery make the approach well suited for hysterectomy and other gynecological procedures. The removal of specimens excised during surgery has been a challenge that has been answered by the use of power morcellation. With this study we sought to assess the feasibility of power morcellation within a specimen bag. METHODS: This was a retrospective cohort study including patients from a private practice in suburban Chicago, Illinois, who underwent contained electromechanical power morcellation during a laparoscopic or robot-assisted hysterectomy or myomectomy from May 2014 through December 2015...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28336363/does-surgical-teaching-take-time-resident-participation-in-minimally-invasive-hysterectomy-for-endometrial-cancer
#15
Alexandra H Freeman, Allison Barrie, Liisa Lyon, Carol Conell, Christine Garcia, Ramey D Littell, C Bethan Powell
STUDY OBJECTIVE: To determine the association between resident involvement and operative time for minimally invasive surgery (MIS) for endometrial cancer. DESIGN: Retrospective cohort study DESIGN: Classification: II-2 SETTING: Integrated health care system in Northern California PATIENTS: A total of 1,433 women who underwent MIS for endometrial cancer and endometrial intraepithelial neoplasia from January 2009 to January 2014. INTERVENTIONS: Resident participation in 430/688 laparoscopic cases (62%) and 341/745 robotic cases (46%)...
March 21, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28331901/isolated-port-site-recurrence-of-node-negative-clinical-stage-ib1-cervical-adenocarcinoma
#16
Uma Deshmukh, Molly McAdow, Jonathan Black, Pei Hui, Masoud Azodi
INTRODUCTION: Port site metastasis after laparoscopic surgery for cervical cancer is a rare phenomenon. METHODS: We present a case report of isolated port site recurrence 4 years following laparoscopic surgery in a patient with node-negative, clinical stage IB1 cervical adenocarcinoma. RESULTS: A 44 year-old woman presented with a necrotic cervical lesion. A biopsy of the mass revealed invasive endocervical adenocarcinoma. She underwent a robotic-assisted radical hysterectomy, bilateral salpingectomy, and pelvic lymph node dissection with bilateral oophoropexy...
May 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28290977/actinomyces-related-tubo-ovarian-abscess-in-a-poorly-controlled-type-ii-diabetic-with-a-copper-intrauterine-device
#17
Ashley L Sawtelle, Nicole P Chappell, Caela R Miller
BACKGROUND: The historic association of Actinomyces israelii infection with intrauterine devices (IUDs) has long been recognized. In recent years, the risk of developing pelvic inflammatory disease with a copper or levonorgestrel IUD has been less than 1% in women who are low risk for sexually transmitted infections. IUD-related pelvic infections secondary to actinomyces have largely vanished from contemporary practice. CASE: A 49-year-old using a copper IUD for contraception with poorly controlled type II diabetes mellitus was admitted for suspected tubo-ovarian abscess on the basis of abdominopelvic pain, leukocytosis, and computed tomography findings...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28277596/the-mccarus-volker-fornisee%C3%A2-a-novel-trans-illuminating-colpotomy-device-and-uterine-manipulator-for-use-in-conventional-and-robotic-assisted-laparoscopic-hysterectomy
#18
Melissa M Gutierrez, Jasmine D Pedroso, K Warren Volker, David L Howard, Steven D McCarus
PURPOSE: The purpose of this paper is to introduce a novel trans-illuminating culdotomy and uterine manipulator device. MATERIALS AND METHODS: The study was a prospective, non-randomized, non-blinded observational clinical study involving 50 female patients undergoing total laparoscopic hysterectomy (TLH) or laparoscopic supracervical hysterectomy (LSH) for benign indications. The surgeries were performed from March through May 2012 at two institutions. The primary study objectives were to demonstrate the safety and adequate clinical performance of the uterine manipulator device and to illustrate its potential widespread future use in minimally invasive gynecologic procedures...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28265777/a-prospective-cohort-study-comparing-colorimetric-and-fluorescent-imaging-for-sentinel-lymph-node-mapping-in-endometrial-cancer
#19
Robert W Holloway, Sarfraz Ahmad, James E Kendrick, Glenn E Bigsby, Lorna A Brudie, Giselle B Ghurani, Nicole M Stavitzski, Jasmine L Gise, Susan B Ingersoll, Julie W Pepe
BACKGROUND: This prospective cohort study aimed to assess sentinel lymph node (SLN) mapping using isosulfan blue (ISB) compared with ISB plus indocyanine green (ICG) and near-infrared imaging (NIR) for patients with endometrial cancer. METHODS: In this study, 200 patients with endometrial cancer underwent SLN assessments and were randomized to ISB + ICG (n = 180) or ISB alone (n = 20). Blue dye determinations were recorded for all 200 cases followed by NIR imaging of ICG for 180 randomized subjects...
March 6, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28263200/increasing-utilization-of-minimally-invasive-hysterectomy
#20
Mark D Walters, Beri M Ridgeway
Once the decision to perform a hysterectomy has been made, the type and route of hysterectomy must be chosen, and efforts made to accomplish the surgery as safely as possible. Hysterectomy can be performed vaginally, abdominally with laparoscopic or robotic assistance, or open. The main goal of gynecologic surgeons should be to lower the rate of open abdominal hysterectomy and increase use of both vaginal and laparoscopic hysterectomy in their patients. We discuss efforts to accomplish a greater use of minimally invasive hysterectomy...
June 2017: Clinical Obstetrics and Gynecology
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