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Saturday, September 21, 2013

Trailers (60): Robotic vs. laparoscopic hysterectomy for benign disease

Rosero et al. Comparison of robotic and laparoscopic hysterectomy for benign gynecologic disease.

Why should you read about this topic?

Because you want to know whether hysterectomy with robotic assistance is really worth the cost

What were the authors trying to do?

Compare clinical outcomes, safety, and cost of robotic hysterectomy with laparoscopic hysterectomy

Who participated and in what setting?

Women (N=15,576) with benign disease undergoing laparoscopic hysterectomy with or without robotic assistance in the National Inpatient Sample between 2009-2010

What was the study design?

Retrospective cohort

What were the main outcome measures?

In-hospital adverse events, length of stay, and hospital costs

What were the results?

Overall complication rates were the same between groups.  Hospital costs averaged $2489 higher for patients undergoing robotic hysterectomy.

What is the most interesting image in the paper?

Table 3

What were the study strengths and weaknesses?

Strengths:  nationwide, population-based database. Weaknesses: no accounting for capital expenses and indirect costs, including privileging

What does the study contribute for your practice?

Robotic hysterectomy is more expensive than laparoscopic hysterectomy but does not provide additional benefit