Comparison of minimally invasive surgical approaches for hysterectomy at a community hospital: robotic-assisted laparoscopic hysterectomy, laparoscopic-assisted vaginal hysterectomy and laparoscopic supracervical hysterectomy.

摘要: The study reported here compares outcomes of three approaches to minimally invasive hysterectomy for benign indications, namely, robotic-assisted laparoscopic (RALH), laparoscopic-assisted vaginal (LAVH) and supracervical (LSH) hysterectomy. total patient cohort comprised the first 237 patients undergoing robotic surgeries at our hospital between August 2007 June 2009; last 100 LAVH by same surgeons July 2006 February 2008 165 LAVHs performed nine January 87 LSH 2009. Among RALH were cases greater complexity: (1) higher prevalence prior abdominopelvic surgery than that found among patients; (2) an increased number procedures endometriosis pelvic reconstruction. Uterine weights also in [207.4 vs. 149.6 (LAVH; P < 0.001) 141.1 g (LSH; = 0.005)]. Despite case complexity, operative time was significantly lower (89.9 124.8 min, similar (89.6 min). Estimated blood loss (167.9 ml) (59.0 ml, or (65.7 0.001). Length stay shorter LSH. Conversion complication rates low across procedures. Multivariable regression indicated LAVH, obesity, uterine weight ≥250 older age predicted longer time. learning curve demonstrated improved over series. Our findings show benefits LAVH. Outcomes can be as good better those LSH, suggesting latter should choice primarily women desiring cervix-sparing surgery.