Perioperative Complications of Robot-Assisted Laparoscopic Surgery Using Three Robotic Arms at a Single Institution
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Purpose: The aim of this study was to evaluate perioperative complications of robot-assisted laparoscopic surgery in gynecology. Materials and Methods: Patientswho underwent elective robot-assisted laparoscopic surgery between February2006 and December 2013 were identified. Robotic procedures were performed using the da Vinci robotic system. Patient demographic data and operative outcomeswere prospectively collected in a computerized database and extracted for this study. Results: Two hundred and ninety eight patients were identified during the study period. One case was converted to conventional laparoscopy due to mechanicalfailure of the robot system before the procedure and excluded from review. The median age and body mass index of patients were 48 years and 23.0 kg/m2, respectively. The majority (n=130, 43.6%) of operative procedures was radical hysterectomy, followed by endometrial cancer staging (n=112, 37.6%), total hysterectomy(n=39, 13.1%), and myomectomy (n=17, 5.7%). The median operative time, estimated blood loss, and postoperative hospital stay were 208.5 min, 184.8 mL, and 8.9 days, respectively. The overall complication rate was 18.8% and that for only oncologic cases was 16.1%. Intraoperative complications (n=5, 1.7%) consisted of three vessel injuries, one bowel content leakage during an appendectomyduring endometrial cancer staging and one case of bladder injury during radicalhysterectomy. Early and late postoperative complications were 14.4% and 2.7%, respectively. Five patients (1.7%) experienced grade 3 complications accordingto Clavien-Dindo classification and therefore needed further intervention. Conclusion: Robot-assisted laparoscopic surgery is a feasible approach in gynecologywith acceptable complications.
Abstract
Purpose: The aim of this study was to evaluate perioperative complications of robot-assisted laparoscopic surgery in gynecology. Materials and Methods: Patientswho underwent elective robot-assisted laparoscopic surgery between February2006 and December 2013 were identified. Robotic procedures were performed using the da Vinci robotic system. Patient demographic data and operative outcomeswere prospectively collected in a computerized database and extracted for this study. Results: Two hundred and ninety eight patients were identified during the study period. One case was converted to conventional laparoscopy due to mechanicalfailure of the robot system before the procedure and excluded from review. The median age and body mass index of patients were 48 years and 23.0 kg/m2, respectively. The majority (n=130, 43.6%) of operative procedures was radical hysterectomy, followed by endometrial cancer staging (n=112, 37.6%), total hysterectomy(n=39, 13.1%), and myomectomy (n=17, 5.7%). The median operative time, estimated blood loss, and postoperative hospital stay were 208.5 min, 184.8 mL, and 8.9 days, respectively. The overall complication rate was 18.8% and that for only oncologic cases was 16.1%. Intraoperative complications (n=5, 1.7%) consisted of three vessel injuries, one bowel content leakage during an appendectomyduring endometrial cancer staging and one case of bladder injury during radicalhysterectomy. Early and late postoperative complications were 14.4% and 2.7%, respectively. Five patients (1.7%) experienced grade 3 complications accordingto Clavien-Dindo classification and therefore needed further intervention. Conclusion: Robot-assisted laparoscopic surgery is a feasible approach in gynecologywith acceptable complications.
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