Journal
ARCHIVES OF GYNECOLOGY AND OBSTETRICS
Volume 285, Issue 2, Pages 435-440Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00404-011-1999-2
Keywords
Myomectomy; Non-invasive surgery; Robot-assisted laparoscopic myomectomy
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Funding
- Research & Education for Academic Achievement (REACH) Network
- Northwestern University Clinical and Translational Sciences Institute (NUCATS)
- NIH [UL1RR025741]
- Evergreen Invitational Grand Prix Women's Health Grants Initiative
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To compare clinical and effectiveness outcomes between robotic-assisted laparoscopic myomectomy (RALM) and abdominal myomectomy (AM). Records were reviewed for the first 27 RALM procedures at our institution. Age, BMI, insurance status, race, uterine size, and operative indication were used to select comparable patients who had undergone AM. Clinical and efficiency outcomes were compared stratifying for uterine size, specimen weight, and matched propensity scores. IV hydromorphone use was significantly lower for RALM (P < 0.01), with no significant differences in blood loss or complications. RALM patients had significantly shorter hospital stays; however, total hospital charges were higher (P < 0.0001). This likely reflects longer operating room time (P < 0.0001), which was magnified as specimen size increased (P < 0.0001). RALM patients require less IV hydromorphone, have shorter hospital stays, and have generally equivalent clinical outcomes compared with AM patients. Additionally, as specimen size increased, the operative efficiency of RALM decreased compared with AM.
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