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Clinical Reviews

The robot is gaining ground in gynecologic surgery. Should you be using it?

Six experts exchange viewpoints on whether increasing use of the robot is warranted in benign gynecologic surgery

April 2013 · Vol. 25, No. 4


What do the data reveal about the robot in benign gynecology?

Should the robot be used for benign hysterectomy?

Advice for the surgeon

This week's quiz:
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To read 9 recent articles from OBG Management on the pros and cons of robotic surgery, click here.

The publication of a large cohort study of hysterectomy for benign indications revived a debate over robotic assistance in gynecologic surgery.1 The study—by Jason D. Wright, MD, and colleagues—included 264,758 women who underwent hysterectomy for benign indications in 441 US hospitals from 2007 to 2010, and it produced some dramatic findings:

  • The use of robotic assistance increased from 0.5% of all hysterectomies in 2007 to 9.5% in 2010
  • Three years after the first robotic procedure in each hospital where robotics were used, robotic-assisted hysterectomy accounted for 22.4% of all hysterectomies
  • Laparoscopic hysterectomy increased as well, from 24.3% of all hysterectomies in the first quarter of 2007 to 30.5% in the first quarter of 2010
  • The rate of vaginal hysterectomy declined from 21.7% to 19.8% of all hysterectomies during the same time period
  • Abdominal hysterectomy decreased from 53.6% to 43.1% of all hysterectomies
  • Although robotic-assisted and laparoscopic hysterectomy had similar complication rates, transfusion requirements, and rates of discharge to a nursing facility, the robotic-assisted approach cost $2,189 more.1

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