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Trends in Route of Hysterectomy With the Implementation of a Comprehensive Robotics Training Program [21B]

Fisher, Jay, MD; Betcher, Katie, MD

doi: 10.1097/01.AOG.0000483340.25476.3b
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INTRODUCTION: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.