Document Detail


Robotic tubal anastomosis: surgical technique and cost effectiveness.
MedLine Citation:
PMID:  18054354     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the feasibility of robotic microsurgical tubal anastomosis and compare the results and cost effectiveness with the same procedure performed by laparotomy. DESIGN: Prospective cohort study. SETTING: University hospital. PATIENT(S): Patients with a history of bilateral tubal ligation who desired reversal for future fertility. INTERVENTION(S): Tubal anastomoses through either a robotic approach or through a laparotomy. MAIN OUTCOME MEASURE(S): Operative times, hospitalization, complications, postoperative patency, clinical outcomes, and the cost per live birth. RESULT(S): The mean operative time for robotic anastomoses was statistically significantly greater than open anastomoses (ROBOT 201 minutes; OPEN 155.3 minutes), although hospitalization times were statistically significantly shorter (ROBOT 4 hours; OPEN 34.7 hours). The return to instrumental activities of daily living was accelerated in the patients who had undergone a robotic anastomosis (ROBOT 11.1 days; OPEN 28.1 days). Although this was a small series, the pregnancy rates were comparable between groups (ROBOT 62.5%; OPEN 50%), yet the rate of abnormal pregnancy was higher in the robotic group (ectopic: ROBOT 4, OPEN 1; spontaneous pregnancy loss: ROBOT 2, OPEN 1). The cost per delivery was similar between the groups (ROBOT $92,488.00, OPEN $92,205.90). CONCLUSION(S): Robotically assisted laparoscopic microsurgical tubal anastomosis is feasible and cost effective with results that are comparable with the traditional open approach.
Authors:
Sejal P Dharia Patel; Michael P Steinkampf; Scott J Whitten; Beth A Malizia
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2007-12-03
Journal Detail:
Title:  Fertility and sterility     Volume:  90     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2008-11-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1175-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, the Ohio State University, Columbus, Ohio 43210, USA. dhariavxr@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Anastomosis, Surgical / economics*,  methods,  statistics & numerical data
Cost-Benefit Analysis
Fallopian Tubes / surgery*
Feasibility Studies
Female
Health Care Costs / statistics & numerical data*
Humans
Infertility, Female / economics*,  surgery*
Laparotomy / economics,  statistics & numerical data
Pregnancy
Pregnancy Outcome / economics
Robotics / economics*,  statistics & numerical data
Surgery, Computer-Assisted / economics*,  statistics & numerical data
Treatment Outcome
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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