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Robotic-Assisted and Laparoscopic Sacrocolpopexy: Comparing Operative Times, Costs and Outcomes

Tan-Kim, Jasmine MD*†; Menefee, Shawn A. MD; Luber, Karl M. MD; Nager, Charles W. MD*; Lukacz, Emily S. MD*

Female Pelvic Medicine & Reconstructive Surgery: January-February 2011 - Volume 17 - Issue 1 - p 44-49
doi: 10.1097/SPV.0b013e3181fa44cf
Original Article
Journal Club

Objectives: To compare operative times, hospital costs, and surgical outcomes for robotic-assisted laparoscopic sacrocolpopexy (RALSC) and laparoscopic sacrocolpopexy (LSC).

Methods: A retrospective cohort study of 104 subjects who underwent RALSC (n = 43) or LSC (n = 61) for vaginal vault prolapse was performed. The primary outcomes were operative time and hospital costs. The secondary outcomes included blood loss, complications, and objective cure rates. χ2 and t tests were used.

Results: The mean operative time was longer in RALSC than in LSC (281 ± 58 vs 206 ± 42 minutes; P < 0.001) with setup time accounting for only 9 minutes of this difference. Direct costs (expressed in cost units) for hospital stay were similar (437 ± 88 vs 450 ± 119 units; P = 0.738) while surgical costs remained higher for RALSC (2724 ± 413 vs 2295 ± 342 units; P < 0.01). Blood loss and complications were similar, and objective cure was not significantly different for RALSC vs LSC (90% vs 80%, P = 0.19).

Conclusions: Robotic-assisted laparoscopic sacrocolpopexy achieves similar perioperative outcomes compared to LSC with increased surgical time resulting in increased costs.

Compared to conventional laparoscopy, robotic-assisted laparoscopic sacrocolpopexy is associated with longer operative times which translate into increased costs, but similar surgical anatomical outcomes, blood loss, and complications.

From the *Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Reproductive Medicine, University of California, San Diego, La Jolla; and †Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Kaiser Permanente San Diego, San Diego, CA.

Address correspondence to Emily S. Lukacz, MD, University of California, San Diego Women's Pelvic Medicine Center, 9350 Campus Point Dr, Suite 2A, La Jolla, CA 92037. E-mail: elukacz@ucsd.edu.

Reprints: Jasmine Tan-Kim, MD, University of California, San Diego Women's Pelvic Medicine Center, 9350 Campus Point Dr, Suite 2A, La Jolla, CA 92037. E-mail: jstan@ucsd.edu.

This study was conducted in La Jolla and San Diego, CA.

Drs Nager and Lukacz are both consultants for Intuitive Surgical, Inc. Dr Nager is also a proctor for Intuitive Surgical, Inc.

No source of funding was used for this study.

© 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins