Robotic tubal anastomosis: surgical technique and cost effectiveness

被引:69
作者
Patel, Sejal P. Dharia [1 ]
Steinkampf, Michael P. [2 ]
Whitten, Scott J. [3 ]
Malizia, Beth A. [4 ]
机构
[1] Ohio State Univ, Dept Obstet & Gynecol, Div Reprod Endocrinol & Infertil, Columbus, OH 43210 USA
[2] Alabama Fertil Specialists, Birmingham, AL USA
[3] Univ Alabama Birmingham, Dept Obstet & Gynecol, Birmingham, AL 35294 USA
[4] Beth Israel Deaconess Med Ctr, Dept Obstet & Gynecol, Boston, MA 02215 USA
关键词
tubal anastomosis; robotic-assisted surgery; tubal surgery; cost-effectiveness;
D O I
10.1016/j.fertnstert.2007.07.1392
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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): Tuba 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.
引用
收藏
页码:1175 / 1179
页数:5
相关论文
共 25 条
  • [1] Robotic surgery, telerobotic surgery, telepresence, and telementoring - Review of early clinical results
    Ballantyne, GH
    [J]. SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2002, 16 (10): : 1389 - 1402
  • [2] Ergonomic problems associated with laparoscopic surgery
    Berguer, R
    Forkey, DL
    Smith, WD
    [J]. SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES, 1999, 13 (05): : 466 - 468
  • [3] Robotically assisted laparoscopic microsurgical tubal reanastomosis:: a feasibility study
    Degueldre, M
    Vandromme, J
    Huong, PT
    Cadière, GB
    [J]. FERTILITY AND STERILITY, 2000, 74 (05) : 1020 - 1023
  • [4] *DEP LAB, BUR WAG EARN BEN
  • [5] DIVERS WA, 1984, FERTIL STERIL, V41, P233
  • [6] Robotics in gynecology
    Falcone, T
    Goldberg, JM
    [J]. SURGICAL CLINICS OF NORTH AMERICA, 2003, 83 (06) : 1483 - +
  • [7] Robotic-assisted laparoscopic microsurgical tubal anastomosis: a human pilot study
    Falcone, T
    Goldberg, JM
    Margossian, H
    Stevens, L
    [J]. FERTILITY AND STERILITY, 2000, 73 (05) : 1040 - 1042
  • [8] Laparoscopic microsurgical tubal anastomosis with and without robotic assistance
    Goldberg, JM
    Falcone, T
    [J]. HUMAN REPRODUCTION, 2003, 18 (01) : 145 - 147
  • [9] Poststerilization regret: Findings from the United States collaborative review of sterilization
    Hillis, SD
    Marchbanks, PA
    Tylor, LR
    Peterson, HB
    [J]. OBSTETRICS AND GYNECOLOGY, 1999, 93 (06) : 889 - 895
  • [10] Laparoscopic microsurgical tubal anastomosis
    Koh, CH
    Janik, GM
    [J]. OBSTETRICS AND GYNECOLOGY CLINICS OF NORTH AMERICA, 1999, 26 (01) : 189 - +