The impact of robotics on the mode of benign hysterectomy and clinical outcomes

Background The impact of robotics on benign hysterectomy surgical approach, clinical outcomes, and learning curve is still unclear. Methods Review of abdominal, vaginal, laparoscopic, or robotic cases in 156 US hospitals in the Premier Research Database. Results Of 289 875 hysterectomies, abdominal cases decreased from 2005–2010 (60–33%) and minimally invasive approaches increased (40–67%). Conversion rates were: 0.04% for vaginal, 2.5% for robotic, and 7.2% for laparoscopy (P < 0.001). Robotic surgery time was longest (3.4 h vs. 2.2 vaginal, 2.5 abdominal, 2.7 laparoscopy, P < 0.001). Robotic complication rate was lowest (14.8% vs. 16.2% vaginal, 18.6% laparoscopy, 28.9% abdominal, P < 0.001). Hospital stay was longer following abdominal surgery (3.5 days vs. 1.8 robotic, 1.9 vaginal, 1.8 laparoscopy, P < 0.001). Robotic surgery times and conversion and complication rates improved with experience (2.8 h, 2%, and 13.9%, respectively), even with increasing complexity. Conclusions Robotics was successfully incorporated without jeopardizing patient outcomes and increased the overall use of minimally invasive approaches. Copyright © 2015 John Wiley & Sons, Ltd.