Evaluation of the introduction of robotic technology on route of hysterectomy and complications in the first year of use.

Abstract

We sought to determine the differential rates and complications of hysterectomy type in the year prior to and following the introduction of robotic technology. This was a retrospective chart review of 461 hysterectomies performed from July 2007 through June 2008 (period 1) and July 2008 through June 2009 (period 2) at Virginia Commonwealth University Medical Center. In all, 199 vs 262 hysterectomies were performed in periods 1 and 2: open, 52.3% vs 43.1%; laparoscopic, 18.1% vs 8.0%; robotic, 2.5% vs 24.8%; and vaginal, 27.4% vs 24.1%, respectively. The increase in robotic hysterectomies in period 2 was associated only with a decline in laparoscopic hysterectomy (P < .0001). Major morbidity by route was 23.04% open, 11/1% vaginal, 7.02% laparoscopic, and 4.29% robotic (P < .0001). Route of hysterectomy changed significantly after the introduction of robotic technology primarily due to a change in management of pelvic organ prolapse. Open hysterectomy was associated with significantly higher complication rates.