Robotic-assisted laparoscopic myomectomy versus abdominal myomectomy: a comparative analysis of surgical outcomes and costs

Arch Gynecol Obstet. 2012 Feb;285(2):435-40. doi: 10.1007/s00404-011-1999-2. Epub 2011 Jul 22.

Abstract

Objective: To compare clinical and effectiveness outcomes between robotic-assisted laparoscopic myomectomy (RALM) and abdominal myomectomy (AM).

Study design: Records were reviewed for the first 27 RALM procedures at our institution. Age, BMI, insurance status, race, uterine size, and operative indication were used to select comparable patients who had undergone AM. Clinical and efficiency outcomes were compared stratifying for uterine size, specimen weight, and matched propensity scores.

Results: IV hydromorphone use was significantly lower for RALM (P < 0.01), with no significant differences in blood loss or complications. RALM patients had significantly shorter hospital stays; however, total hospital charges were higher (P < 0.0001). This likely reflects longer operating room time (P < 0.0001), which was magnified as specimen size increased (P < 0.0001).

Conclusion: RALM patients require less IV hydromorphone, have shorter hospital stays, and have generally equivalent clinical outcomes compared with AM patients. Additionally, as specimen size increased, the operative efficiency of RALM decreased compared with AM.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen / surgery
  • Adult
  • Analgesics, Opioid / administration & dosage
  • Female
  • Hospital Charges
  • Humans
  • Hydromorphone / administration & dosage
  • Laparoscopy* / adverse effects
  • Laparoscopy* / economics
  • Leiomyoma / economics
  • Leiomyoma / pathology
  • Leiomyoma / surgery*
  • Length of Stay
  • Logistic Models
  • Retrospective Studies
  • Robotics* / economics
  • Statistics, Nonparametric
  • Treatment Outcome
  • Uterine Neoplasms / economics
  • Uterine Neoplasms / pathology
  • Uterine Neoplasms / surgery*

Substances

  • Analgesics, Opioid
  • Hydromorphone