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Robotic hysterectomy

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https://www.readbyqxmd.com/read/28624984/the-senhance%C3%A2-surgical-robotic-system-senhance-for-total-hysterectomy-in-obese-patients-a-pilot-study
#1
Salvatore Gueli Alletti, C Rossitto, S Cianci, E Perrone, S Pizzacalla, G Monterossi, G Vizzielli, S Gidaro, G Scambia
This pilot study was aimed to value the feasibility and safety of Senhance Robotic Platform for hysterectomy in obese patients. Ten obese patients (30 < BMI < 40) underwent elective Senhance total extrafascial hysterectomy with bilateral salpingo-oophorectomy at the Division of Gynecologic Oncology of "Policlinico A. Gemelli" Foundation, Rome, Italy. Perioperative and postoperative outcomes data were recorded. The median age was 60 years (range 51-75) and the median BMI was 33.3 kg/m(2) (range 30...
June 17, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28604450/low-volume-lymph-node-metastases-in-endometrial-carcinoma
#2
Lani K Clinton, Jordan Kondo, Michael E Carney, Pamela Tauchi-Nishi, Keith Terada, David Shimizu
OBJECTIVE: The aim of this study was to determine the histopathologic characteristics of patients with endometrial carcinoma with low-volume metastases (micrometastases and isolated tumor cells) compared with macrometastases. METHODS: We performed a retrospective review of patients with endometrial carcinoma. RESULTS: Among 350 robotic-assisted hysterectomies for endometrial cancer, 187 (53%) underwent attempted sentinel lymph node (SLN) biopsy...
June 10, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28603473/perioperative-surgical-outcome-of-conventional-and-robot-assisted-total-laparoscopic-hysterectomy
#3
W J van Weelden, B B M Gordon, E A Roovers, A A Kraayenbrink, C I M Aalders, F Hartog, F P H L J Dijkhuizen
BACKGROUND: To evaluate surgical outcome in a consecutive series of patients with conventional and robot assisted total laparoscopic hysterectomy. METHODS: A retrospective cohort study was performed among patients with benign and malignant indications for a laparoscopic hysterectomy. Main surgical outcomes were operation room time and skin to skin operating time, complications, conversions, rehospitalisation and reoperation, estimated blood loss and length of hospital stay...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/28599884/comparing-single-site-and-multiport-robotic-hysterectomy-with-sentinel-lymph-node-mapping-for-endometrial-cancer-surgical-outcomes-and-cost-analysis
#4
Lea A Moukarzel, Abdulrahman K Sinno, Amanda N Fader, Edward J Tanner
STUDY OBJECTIVE: To compare operative times, surgical outcomes, and costs of robotic laparo-endoscopic single-site (R-LESS) versus multiport robotic (MPR) total laparoscopic hysterectomy (TLH) with sentinel lymph node (SLN) mapping for low risk endometrial cancer. DESIGN: Retrospective cohort study (Canadian Task Force Classification Level II-2) SETTING: Academic university hospital PATIENTS: Patients with biopsy proven diagnosis of complex atypical hyperplasia (CAH) or low grade (1 or 2) endometrial cancer with body mass index less than 30 kg/m(2) and a undergoing robotic TLH and SLN mapping between 2012 and 2016 were included...
June 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28599164/impact-of-power-morcellator-removal-on-hysterectomy-practice-patterns
#5
Adrianne Wesol, Shauna Woolley
OBJECTIVE: This study was a quality improvement project investigating patterns of hysterectomy practice including changes in surgical techniques and patient outcomes after manufacturer withdrawal of a laparoscopic power morcellator from our hospitals in July 2014. STUDY DESIGN: This time-series pre and post retrospective review examined data from electronic health records, comparing one year when a laparoscopic power morcellator was available (Year 1, mid-2013 to mid-2014) to one year after withdrawal (Year 2, mid-2014 to mid-2015)...
May 21, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28578175/trends-in-hysterectomy-rates-among-women-veterans-in-the%C3%A2-us-department-of-veterans-affairs
#6
Jodie G Katon, Kristen Gray, Lisa Callegari, Carolyn Gardella, Carolyn Gibson, Erica Ma, Kristine E Lynch, Laurie Zephyrin
BACKGROUND: Prior studies demonstrate a higher prevalence of hysterectomy among veterans compared with nonveterans. While studies identify overall decreasing hysterectomy rates in the United States, none report rates of hysterectomy among women veterans. Given the increasing numbers of women veterans using Veterans Affairs health care, there is an ongoing need to ensure high-quality gynecology care. Therefore, it is important to examine current hysterectomy trends, including proportion of minimally invasive surgeries, among veterans using Veterans Affairs health care...
May 31, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28566135/how-to-set-up-a-robotic-assisted-laparoscopic-surgery-center-and-training-of-staff
#7
REVIEW
John P Lenihan
The use of computers to assist surgeons in the operating room has been an inevitable evolution in the modern practice of surgery. Robotic-assisted surgery has been evolving now for over two decades and has finally matured into a technology that has caused a monumental shift in the way gynecologic surgeries are performed. Prior to robotics, the only minimally invasive options for most Gynecologic (GYN) procedures including hysterectomies were either vaginal or laparoscopic approaches. However, even with over 100 years of vaginal surgery experience and more than 20 years of laparoscopic advancements, most gynecologic surgeries in the United States were still performed through an open incision...
May 10, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28560234/robotic-single-site-supracervical-hysterectomy-with-manual-morcellation-preliminary-experience
#8
Dah-Ching Ding, Mun-Kun Hong, Tang-Yuan Chu, Yu-Hsun Chang, Hwan-Wun Liu
AIM: To evaluate the feasibility, safety and peri- and postoperative outcomes of robotic single-site supracervical hysterectomy (RSSSH) for benign gynecologic disease. METHODS: We report 3 patients who received RSSSH for adenomyosis of the uterus from November 2015 to April 2016. We evaluated the feasibility, safety and outcomes among these patients. RESULTS: The mean surgical time was 244 min and the estimated blood loss was 216 mL, with no blood transfusion necessitated...
May 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28551090/role-of-robotic-surgery-in-treating-fibroids-and-benign-uterine-mass
#9
REVIEW
Suejin Kim, Thanh Ha Luu, Natalia Llarena, Tommaso Falcone
Fibroid uterus can be managed medically, surgically, or through non-extirpative procedures, depending on the clinical situation. Myomectomy may be beneficial, especially to those desiring to preserve the uterus and/or fertility, with outcomes comparable to those of hysterectomy, with a laparoscopic approach being favored when feasible. For definitive therapy, hysterectomy can be pursued where the surgical approach should be individualized. Comparison of robotic-assisted laparoscopic approach shows that the robotic approach may be favored for cases with higher complexity and multiple fibroids in myomectomy; however, no clear advantage is seen with hysterectomy at this time, necessitating further research in the area of robotics for hysterectomy in benign uterine mass treatment to justify the cost...
April 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28533153/role-of-robotic-surgery-in-cervical-malignancy
#10
REVIEW
Jeong-Yeol Park, Joo-Hyun Nam
Surgical treatment is the mainstay of the management of early-stage cervical cancer. Abdominal radical hysterectomy and trachelectomy have long been the standard surgical approach to early-stage cervical cancer, achieving excellent survival outcomes. Recently, laparoscopic radical hysterectomy and trachelectomy have become the preferred alternative to abdominal surgery because laparoscopic approaches lead to better surgical outcomes without compromising survival outcomes. Since the robotic surgery platform was approved for the use of gynaecologic surgery in 2005, robotic radical hysterectomy and trachelectomy have been increasingly used in the surgical management of early-stage cervical cancer...
April 24, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28530129/do-single-use-medical-devices-containing-biopolymers-reduce-the-environmental-impacts-of-surgical-procedures-compared-with-their-plastic-equivalents
#11
Scott R Unger, Troy A Hottle, Shakira R Hobbs, Cassandra L Thiel, Nicole Campion, Melissa M Bilec, Amy E Landis
Background While petroleum-based plastics are extensively used in health care, recent developments in biopolymer manufacturing have created new opportunities for increased integration of biopolymers into medical products, devices and services. This study compared the environmental impacts of single-use disposable devices with increased biopolymer content versus typically manufactured devices in hysterectomy. Methods A comparative life cycle assessment of single-use disposable medical products containing plastic(s) versus the same single-use medical devices with biopolymers substituted for plastic(s) at Magee-Women's Hospital (Magee) in Pittsburgh, PA and the products used in four types of hysterectomies that contained plastics potentially suitable for biopolymer substitution...
January 1, 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28528932/robot-assisted-gynaecological-cancer-surgery-complications-and-prevention
#12
REVIEW
Ka Yu Tse, Hextan Yuen Sheung Ngan, Peter Christopher Lim
Ever since the US Food and Drug Administration approval of the use of da Vinci surgical systems (Intuitive Surgical Inc., Sunnyvale, California) in gynaecology in 2005, robot-assisted surgery has been widely adopted in different countries. Some of the applications in benign and oncological gynaecology include myomectomy, sacrocolpopexy, tubal anastomosis, simple hysterectomy, radical hysterectomy, radical trachelectomy, pelvic and/or para-aortic lymphadenectomy and even debulking surgery for ovarian cancer and pelvic exenteration for recurrent cervical and vaginal cancer...
April 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
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
#13
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
#14
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
#15
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
#16
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...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28486359/minimally-invasive-hysterectomy-and-power-morcellation-trends-in-a-west-coast-integrated-health-system
#17
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...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28483536/comparison-of-morcellation-techniques-at-time-of-laparoscopic-hysterectomy-and-myomectomy
#18
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
#19
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
#20
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
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