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Robotic hysterectomy

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https://www.readbyqxmd.com/read/28508348/cost-analysis-of-minimally-invasive-radical-hysterectomy-for-cervical-cancer-performed-by-a-single-surgeon-in-an-italian-center-an-update-in-gynecologic-oncological-field
#1
Antonio Pellegrino, Gianluca Raffaello Damiani, Giorgio Fachechi, Cecilia Pirovano, Maria Gaetani, Aly Youssef
The objective of this study is to perform an economic analysis and examine the influence of procedural volume of our hospital, evaluating the accounting systems of Robotic radical hysterectomy (RRH) vs Laparoscopic radical hysterectomy (TLRH) in patients with cervical carcinoma, due to the costs widely variable and lack in literature. Costs were collected prospectively, from March 2010 to March 2016. Direct costs were determined by examining the overall medical pathway for each type of intervention. 52 patients with cervical carcinoma, which were matched by age, body mass index, tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage, comorbidity, previous neoadjuvant chemotherapy, histology type, and tumor grade to obtain homogeneous samples...
May 15, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28506944/effect-of-sacrocolpopexy-and-retropubic-sling-on-overactive-bladder-symptoms
#2
Muhammad Faisal Aslam, William T Gregory, Blake Osmundsen
OBJECTIVE: In this study, we aimed to evaluate the effect of sacrocolpopexy and retropubic midurethral sling, or transvaginal tape (TVT) procedure, on overactive bladder (OAB) symptoms. Our null hypothesis was that concomitant sacrocolpopexy and TVT exacerbate OAB symptoms. MATERIAL AND METHODS: This is a prospective cohort study. All subjects had apical/anterior prolapse and underwent robotic-assisted sacrocolpopexy and TVT, with or without concomitant hysterectomy...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28501452/promoting-same-day-discharge-for-gynecologic-oncology-patients-in-minimally-invasive-hysterectomy
#3
Cynthia R Fountain, Laura J Havrilesky
BACKGROUND: Despite clear data demonstrating feasibility, safety, and cost-effectiveness of same-day discharge after minimally invasive hysterectomy, there is a paucity of data suggesting ways to increase same-day discharge rates. OBJECTIVE: To promote same-day discharge following minimally invasive hysterectomy using preoperative patient education videos, provider same-day discharge awareness initiatives, and standardization of postoperative management. To investigate reasons for overnight admission after surgery (non-same-day discharge)...
May 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28486371/trends-in-mode-of-hysterectomy-after-the-u-s-food-and-drug-administration-power-morcellation-advisory
#4
Helga Ottarsdottir, Sarah L Cohen, Mary Cox, Allison Vitonis, Jon I Einarsson
OBJECTIVE: To evaluate the trends in mode of surgery for benign hysterectomy after the 2014 U.S. Food and Drug Administration (FDA) morcellation guidelines. METHODS: This is a retrospective review of all patients who underwent a hysterectomy for benign indications, specifically for leiomyomas, at Brigham and Women's Hospital from 2013 to 2015. The rates of abdominal, vaginal, laparoscopic, and robotic-assisted laparoscopic hysterectomy as well as the perioperative outcomes were compared over the study period...
May 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28486359/minimally-invasive-hysterectomy-and-power-morcellation-trends-in-a-west-coast-integrated-health-system
#5
Eve Zaritsky, Lue-Yen Tucker, Romain Neugebauer, Tatiana Chou, Tracy Flanagan, Andrew J Walter, Tina Raine-Bennett
OBJECTIVE: To examine trends in minimally invasive hysterectomy and power morcellation use over time and associated clinical characteristics. METHODS: We conducted a trend analysis and retrospective cohort study of all women 18 years of age and older undergoing hysterectomy for benign conditions at Kaiser Permanente Northern California collected from electronic health records. Generalized estimating equations and Cochran-Armitage testing were used to assess the primary outcomes, hysterectomy incidence, and proportion of hysterectomies by surgical route and power morcellation...
May 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28483536/comparison-of-morcellation-techniques-at-time-of-laparoscopic-hysterectomy-and-myomectomy
#6
Elsemieke A I M Meurs, Luiz Gustavo Brito, Mobolaji Ajao, Emily R Goggins, Allison F Vitonis, Jon I Einarsson, Sarah L Cohen
STUDY OBJECTIVE: To compare perioperative outcomes associated with the use of three techniques for tissue removal at the time of laparoscopic hysterectomy and myomectomy. DESIGN: Retrospective cohort study. DESIGN CLASSIFICATION: II-2 SETTING: Academic hospital in Boston, MA PATIENTS: Women who underwent a laparoscopic or robot-assisted laparoscopic hysterectomy or myomectomy involving tissue morcellation in 2014. INTERVENTIONS: One of three morcellation techniques: electronic power morcellation (PM), manual morcellation via vagina (VM) or manual morcellation via minilaparotomy (ML)...
May 5, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28463759/robot-assisted-laparoscopy-versus-laparotomy-for-infrarenal-paraaortic-lymphadenectomy-in-women-with-high-risk-endometrial-cancer-a-randomised-controlled-trial
#7
Sahar Salehi, Elisabeth Åvall-Lundqvist, Berit Legerstam, Joseph W Carlson, Henrik Falconer
PURPOSE: To investigate if robot-assisted laparoscopic surgery (RALS) was non-inferior to laparotomy (LT) in harvesting infrarenal paraaortic lymph nodes in patients with presumed stage I-II high-risk endometrial cancer. PATIENTS AND METHODS: Patients with histologically proven endometrial cancer, presumed stage I-II with high-risk tumour features, were randomised to hysterectomy, bilateral salpingo-oophorectomy, pelvic and paraaortic lymphadenectomy by either RALS or LT...
April 29, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28439744/change-in-cost-after-5%C3%A2-years-of-experience-with-robotic-assisted-hysterectomy-for-the-treatment-of-endometrial-cancer
#8
Andrea M Avondstondt, Michelle Wallenstein, Christopher R D'Adamo, Robert M Ehsanipoor
Health care costs are an important consideration in the decision of hysterectomy routes and robotic surgery is often critiqued for its high cost. We sought to compare the cost of robotic-assisted hysterectomies performed after initial acquisition of the robotic surgical system to cases performed after 5 years of experience. The first 20 patients at a community teaching hospital who underwent robotic-assisted hysterectomy for endometrial cancer by a single gynecologic oncology surgeon were designated Group 1 and 20 patients undergoing robotic hysterectomies 5 years later for the same indication were designated Group 2...
April 24, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28430728/the-impact-of-a-dedicated-robotic-team-on-robotic-assisted-sacrocolpopexy-outcomes
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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