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Minimally invasive apical sacropexy: a retrospective review of laparoscopic and robotic operating room experiences.
MedLine Citation:
PMID:  22453324     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: Minimally invasive apical sacropexies (MI-APSC) can be performed using robotics or laparoscopy. We hypothesized that operative characteristics of MI-APSC, laparoscopic (LSC) and robotic (RSC), were similar. The objective of our study was to compare operative characteristics, objective prolapse outcomes, and robotic learning curve.
METHODS: Ninety-two women planning MI-APSC for treatment of apical pelvic organ prolapse from 2006 to 2010 were included in the study. The primary outcome was operative time. The secondary outcomes included estimated blood loss, rate of conversion, intraoperative complications, hospital stay, and objective prolapse outcome. We also analyzed the robotic learning curve. Statistical analysis included independent samples t test, Wilcoxon rank sum test, χ, and multiple logistic regressions; significance was set at P < 0.05. Learning curve was graphed with moving average and analyzed with moving block technique.
RESULTS: Forty-eight RSCs and 43 LSCs were analyzed. Mean operative times were LSC, 238 ± 59 minutes; and RSC, 242 ± 54 minutes. Robotic MI-APSC setup was longer (P = 0.02). Complications, conversions, estimated blood loss and hospital stay were low and similar between groups. Patients' characteristics were similar. Concomitant procedures produced longer operative times.
CONCLUSIONS: Operating room experiences with laparoscopic- and robotic-assisted approaches to MI-APSC were similar, but setup time is longer for the robotic-assisted approach. The robotic learning curve is short for surgeons who have experience with LSC.
Authors:
Samantha J Pulliam; Milena M Weinstein; May M Wakamatsu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Female pelvic medicine & reconstructive surgery     Volume:  18     ISSN:  2151-8378     ISO Abbreviation:  Female Pelvic Med Reconstr Surg     Publication Date:    2012 Mar-Apr
Date Detail:
Created Date:  2012-03-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528690     Medline TA:  Female Pelvic Med Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  122-6     Citation Subset:  IM    
Affiliation:
From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Vincent Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
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