To evaluate trends in mode of hysterectomy performed at a large teaching hospital and a small community hospital over a 5 year period following the implementation of a comprehensive robotics training program.
A review of hysterectomies done at a large teaching hospital and a smaller, community hospital in the same health system over a 5 year period was performed to determine how many hysterectomies were performed using an open, laparoscopic, or vaginal approach. The study included 5175 women, and was evaluated after the implementation of a comprehensive teaching, training, mentoring and proctoring program at each hospital. Laparoscopic procedures included TLH and LSCH, as well as RATLH and RASCH. Vaginal Hysterectomies included TVH and LAVH cases.
We found a significant decrease in the percent of cases performed through an open approach over the course of the study, with a concurrent significant increase in the percent of robotic procedures performed. There was also a significant decrease in the percent of case performed vaginally over this period, but this was only observed at the smaller community hospital site.
At the larger, teaching hospital, the implementation of a comprehensive robotics training program was associated with a significant conversion of cases performed through an open approach to a robotic assisted laparoscopic approach. This was not associated with a decline in the percent of vaginal cases performed. At the smaller, community hospital, more dramatic increases were observed with respect to robotic hysterectomies: however, a decline in the percent of cases performed vaginally was observed.
Oakland University William Beaumont School of Medicine, Royal Oak, MI
Financial Disclosure: The authors did not report any potential conflicts of interest.