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June 12, 2013

Robotic vs Laparoscopic Hysterectomy—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Departments of Obstetrics and Gynecology (Dr Wright; jw2459@columbia.edu) and Medicine (Dr Hershman), Columbia University College of Physicians and Surgeons, New York, New York.

JAMA. 2013;309(22):2320-2321. doi:10.1001/jama.2013.5689

In Reply: Dr Maruthappu and colleagues suggest that robotic surgery is likely associated with a learning curve. Furthermore, given that robotically assisted hysterectomy is a new surgical modality, our findings may not capture the true benefits of the procedure because many surgeons are gaining experience with the operation.

We agree that robotic surgery is associated with a learning curve. Prior work for robotic hysterectomy, as well as other robotic procedures, has suggested that a relatively large number of procedures must be performed to gain proficiency.1,2 It should, however, also be noted that a learning curve is not unique to robotic surgery; previous data have also shown that many operations, including laparoscopic surgeries, are also associated with a learning curve.3,4 Many proponents of robotic gynecologic surgery have suggested that an important benefit of the robotic platform is that it is easier to learn than traditional laparoscopy.