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Erschienen in:
11.07.2023 | Research
Comparison of surgical outcomes between robot-assisted and conventional laparoscopic hysterectomy for large uterus
Erschienen in: Journal of Robotic Surgery | Ausgabe 5/2023
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We compared the effectiveness of conventional total laparoscopic hysterectomy (TLH) against robot-assisted total hysterectomy (RAH) in patients with a large uterus. According to the subtype of minimally invasive hysterectomy performed for benign indications, the patients (n = 843) were grouped as follows: TLH (n = 340) and RAH (n = 503). The median operative time (OT) for TLH was 98 min (47–406 min), and the estimated blood loss (EBL) was 50 mL (5–1800 mL). The median OT for RAH was 90 min (43–251 min), and the EBL was 5 mL (5–850 mL), with a significantly shorter OT and a lower EBL in RAH than in TLH. Uterine weight was categorized into four groups in increments of 250 g. The number of cases in each group was 163 (< 250 g), 116 (250–500 g), 41 (500–750 g), and 20 (≥ 750 g) for TLH, and 308 (< 250 g), 137 (250–500 g), 33 (500–750 g), and 25 (≥ 750 g) for RAH. In patients with a uterus < 250 g, there was no significant difference in OT between TLH and RAH, but in patients with a uterus ≥ 250 g, OT tended to be shorter with RAH, which was also true for a uterus ≥ 750 g. The EBL was significantly lower with RAH compared to TLH, regardless of uterine weight. In patients with a large uterus, the advantages of robotic surgery can be utilized, which may lead to a shorter OT and less EBL.