Strategies to optimize the performance of Robotic-assisted laparoscopic hysterectomy

摘要: A hybrid technique of robot-assisted, laparoscopic hysterectomy using the ENSEAL® Tissue Sealing Device is described in a retrospective, consecutive, observational case series. Over 45 month period, 590 robot-assisted total hysterectomies +/- oophorectomy for benign and malignant indications were performed by single surgeon with bedside assistant at tertiary healthcare center. Patient demographics, surgery, comorbidities, primary secondary surgical procedures, operative time, estimated blood loss (EBL), length stay (LOS), complications, transfusions subsequent readmissions analyzed. The overall complication rate was 5.9% 35 patients experiencing 69 complications. Mean (SD) surgery operating room (OR) EBL, LOS entire cohort 75.5 (39.42) minutes, 123.8 (41.15) 83.1 (71.29) millilitres, 1.2 (0.93) days, respectively. time first year (2009) 91.6 which declined significantly each 18.0, 19.0, 24.3 EBL did not vary ­significantly across Using cumulative sum method, an optimization curve evaluated, three distinct phases observed. In summary, use advanced tissue-sealing device provided improved efficiency reliable vessel sealing during robotic hysterectomy.