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Robotic Hysterectomy for Benign Disease

Article: Robotically Assisted vs Laparoscopic Hysterectomy Among Women With Benign Gynecologic Disease. JAMA. 2013;309(7):689-698.

Summary

Increase seen in robotically assisted hysterectomy for benign disorders, but no associated greater benefit compared to laparoscopic procedures.

Abstract

Importance Although robotically assisted hysterectomy for benign gynecologic conditions has been reported, little is known about the incorporation of the procedure into practice, its complication profile, or its costs compared with other routes of hysterectomy.

Objectives To analyze the uptake of robotically assisted hysterectomy, to determine the association between use of robotic surgery and rates of abdominal and laparoscopic hysterectomy, and to compare the in‑house complications of robotically assisted hysterectomy vs abdominal and laparoscopic procedures.

Design, Setting, and Patients Cohort study of 264 758 women who underwent hysterectomy for benign gynecologic disorders at 441 hospitals across the United States from 2007 to 2010.

Main Outcome Measures Uptake of and factors associated with utilization of robotically assisted hysterectomy. Complications, transfusion, reoperation, length of stay, death, and cost for women who underwent robotic hysterectomy compared with both abdominal and laparoscopic procedures were analyzed.

Results Use of robotically assisted hysterectomy increased from 0.5% in 2007 to 9.5% of all hysterectomies in 2010. During the same time period, laparoscopic hysterectomy rates increased from 24.3% to 30.5%. Three years after the first robotic procedure at hospitals where robotically assisted hysterectomy was performed, robotically assisted hysterectomy accounted for 22.4% of all hysterectomies. The rates of abdominal hysterectomy decreased both in hospitals where robotic‑assisted hysterectomy was performed as well as in those where it was not performed. In a propensity score–matched analysis, the overall complication rates were similar for robotic‑assisted and laparoscopic hysterectomy (5.5% vs 5.3%; relative risk [RR], 1.03; 95% CI, 0.86‑1.24). Although patients who underwent a robotic‑assisted hysterectomy were less likely to have a length of stay longer than 2 days (19.6% vs 24.9%; RR, 0.78, 95% CI, 0.67‑0.92), transfusion requirements (1.4% vs 1.8%; RR, 0.80; 95% CI, 0.55‑1.16) and the rate of discharge to a nursing facility (0.2% vs 0.3%; RR, 0.79; 95% CI, 0.35‑1.76) were similar. Total costs associated with robotically assisted hysterectomy were $2189 (95% CI, $2030‑$2349) more per case than for laparoscopic hysterectomy.

Conclusions and Relevance Between 2007 and 2010, the use of robotically assisted hysterectomy for benign gynecologic disorders increased substantially. Robotically assisted and laparoscopic hysterectomy had similar morbidity profiles, but the use of robotic technology resulted in substantially more costs.

Interview with Jason D. Wright, MD, author of Robotically Assisted vs Laparoscopic Hysterectomy Among Women With Benign Gynecologic Disease.

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Histerectomía robotizada para el tratamiento de enfermedades benignas

Artículo: Histerectomía robotizada frente a laparoscópica en mujeres con enfermedades ginecológicas benignas. JAMA. 2013;309(7):689-698.

Summary

Aumento del número de procedimientos de histerectomía robotizada para el tratamiento de trastornos benignos sin que se observe un mayor beneficio en comparación con los procedimientos laparoscópicos.

Entrevista con Jason D. Wright, MD, autor de Histerectomía robotizada frente a laparoscópica en mujeres con enfermedades ginecológicas benignas.

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Hystérectomie assistée par robot et traitement de maladies gynécologiques bénignes

Article: Hystérectomie assistée par robot ou hystérectomie laparoscopique chez les femmes atteintes d'une maladie gynécologique bénigne. JAMA. 2013;309(7):689-698.

Summary

Augmentation du taux d'hystérectomies assistées par robot dans le traitement des maladies gynécologiques bénignes, sans bénéfice notable associé, par rapport aux procédures laparoscopiques.

Entretien avec Jason D. Wright, MD, auteur de Hystérectomie assistée par robot ou hystérectomie laparoscopique chez les femmes atteintes d'une maladie gynécologique bénigne..

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Isterectomia robotica per la patologia benigna

Articolo: Isterectomia robotica e isterectomia laparoscopica nelle donne con patologia ginecologica benigna. JAMA. 2013;309(7):689-698.

Summary

La maggiore diffusione dell'isterectomia robotica per le patologie benigne non è associata a benefici maggiori rispetto all'uso delle procedure laparoscopiche.

Intervista a Jason D. Wright, MD, autore di Isterectomia robotica e isterectomia laparoscopica nelle donne con patologia ginecologica benigna.

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机器人子宫切除术治疗良性疾病

文章: 女性良性妇科疾病机器人辅助子宫切除术与腹腔镜子宫切除术比较。 JAMA. 2013;309(7):689-698.

Summary

机器人辅助子宫切除术治疗良性疾病的比例有所增高,但与腹腔镜手术相比并无更高效益。

专访 Jason D. Wright, MD, 作者 女性良性妇科疾病机器人辅助子宫切除术与腹腔镜子宫切除术比较。

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Robotic Hysterectomy for Benign Disease

статья: Robotically Assisted vs Laparoscopic Hysterectomy Among Women With Benign Gynecologic Disease. JAMA. 2013;309(7):689-698.

Summary

Перевод отсутствует.

Интервью с Jason D. Wright, MD автор Robotically Assisted vs Laparoscopic Hysterectomy Among Women With Benign Gynecologic Disease.

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Robotic Hysterectomy for Benign Disease

Artigo: Robotically Assisted vs Laparoscopic Hysterectomy Among Women With Benign Gynecologic Disease. JAMA. 2013;309(7):689-698.

Summary

Não há tradução disponível.

Entrevista com o Jason D. Wright, MD autor de Robotically Assisted vs Laparoscopic Hysterectomy Among Women With Benign Gynecologic Disease.

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Roboterassistierte Hysterektomie für benigne Erkrankungen

Artikel: Roboterassistierte gegenüber laparoskopische Hysterektomie bei Frauen mit benignen gynäkologischen Erkrankungen. JAMA. 2013;309(7):689-698.

Summary

Roboterassistierte Hysterektomien für benigne Erkrankungen nehmen zu. Es konnten jedoch keine Vorteile gegenüber laparoskopisch assistierten Verfahren assoziiert werden.

Interview mit Jason D. Wright, MD, autor Roboterassistierte gegenüber laparoskopische Hysterektomie bei Frauen mit benignen gynäkologischen Erkrankungen.

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