Outcomes of Robot-Assisted Laparoscopic Gynecological Surgery: A Tertiary Care Hospital Experience

Abstract

Purpose: We compared the outcomes of robot-assisted (RA) and standard laparoscopic gynecological surgery (S-LGS) in a tertiary care hospital. We also aimed to evaluate factors affecting the outcomes of RA-LGS to identify areas of improvement.

Methods: In this 5-year retrospective study, 65 LGS cases, including 37 RA-LGS and 28 S-LGS, in a single tertiary care hospital were included. Demographic data, clinicopathological details, and complications of the cases were recorded. Surgeons performing RA-LGS were also interviewed regarding their training/experience, competency of surgical assistance, and suggestions for improving training.

Results: Operative times (3.70 ± 0.96 vs. 2.07 ± 0.78 h, p < 0.001) and hospital stays (3.53 ± 3.29 vs. 1.96 ± 1.34 days, p = 0.022) were significantly longer in the RA-LGS group than in the S-LGS group. Intraoperative complications, which were primarily adjacent organ damage (21.6% vs. 0.0%, p = 0.029), were significantly more common in the RA-LGS group. There were no significant differences between the groups in terms of the need to convert to laparotomy, immediate/late postoperative complications, estimated blood loss, or the need for blood transfusion. The interview survey results suggested the lack of a trained team assisting in RA-LGS as the reason for the poor outcomes.

Conclusions: We found no advantages of RA-LGS over S-LGS. Longer training periods for RA-LGS, with minimum 20–50 cases as part of a structured training program, may improve outcomes.