Comparison of Postural Ergonomics Between Laparoscopic and Robotic Sacrocolpopexy: A Pilot Study

Tarr, Megan E.; Brancato, Sam J.; Cunkelman, Jacqueline A.; Polcari, Anthony J.; Nutter, Benjamin; Kenton, Kimberly

doi:10.1016/j.jmig.2014.10.004

Cited by 78 publications

(38 citation statements)

References 25 publications

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“…Over the last 15 years, the number of robot‐assisted procedures performed for the treatment of female pelvic organ prolapse (POP) has increased. This is in part a result of the perceived simplification of complex laparoscopic manoeuvres and improved surgeon ergonomics . Despite this increase, there is a paucity of scientific papers reporting on anatomical outcomes and surgical safety for large groups after robot‐assisted sacrocolpopexy.…”

Section: Introductionmentioning

confidence: 99%

Robot‐assisted surgery for the management of apical prolapse: a bi‐centre prospective cohort study

Zanten

Koops

O’Sullivan

et al. 2019

BJOG

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Objective Robot-assisted surgery is a recognised treatment for pelvic-organ prolapse. Many of the surgical subgroup outcomes for apical prolapse are reported together, leading to a paucity of homogenous data.Design Prospective observational cohort study (NCT01598467, clinicaltrials.gov) assessing outcomes for homogeneous subgroups of robot-assisted apical prolapse surgery.Setting Two European tertiary referral hospitals.Population Consecutive patients undergoing robot-assisted sacrocolpopexy (RASC) and supracervical hysterectomy with sacrocervicopexy (RSHS).Methods Anatomical cure (simplified Pelvic Organ Prolapse Quantification, sPOPQ, stage 1), subjective cure (symptoms of bulge), and quality of life (Pelvic Floor Impact Questionnaire, PFIQ-7).Main outcome measures Primary outcome: anatomical and subjective cure. Secondary outcomes: surgical safety and intraoperative variables.Results A total of 305 patients were included (RASC n = 188; RSHS n = 117). Twelve months follow-up was available for 144 (RASC 76.6%) and 109 (RSHS 93.2%) women. Anatomical success of the apical compartment occurred for 91% (RASC) and in 99% (RSHS) of the women. In all compartments, the success percentages were 67 and 65%, respectively. Most recurrences were in the anterior compartment [15.7% RASC (symptomatic 12.1%); 22.9% RSHS (symptomatic 4.8%)]. Symptoms of bulge improved from 97.4 to 17.4% (P < 0.0005). PFIQ-7 scores improved from 76.7 AE 62.3 to 13.5 AE 31.1 (P < 0.0005). The duration of surgery increased significantly for RSHS [183.1 AE 38.2 versus 145.3 AE 29.8 (P < 0.0005)]. Intraoperative complications and conversion rates were low (RASC, 5.3 and 4.3%; RSHS, 0.0 and 0.0%). Four severe postoperative complications occurred after RASC (2.1%) and one occurred after RSHS (1.6%).Conclusions This is the largest reported prospective cohort study on robot-assisted apical prolapse surgery. Both procedures are safe, with durable results.

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Section: Introductionmentioning

confidence: 99%

Robot‐assisted surgery for the management of apical prolapse: a bi‐centre prospective cohort study

Zanten

Koops

O’Sullivan

et al. 2019

BJOG

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“…6 The literature of evaluated ergonomic issues in obstetrics and gynecology is further limited. 7,[10][11][12][13][14][15][16] In gynecological surgery, the vaginal route is a traditional approach and involves working in a constrained space and in unfavorable postures for long durations. A survey of gynecological surgeons showed that 86.7% of surgeons performing vaginal surgery experienced work-related musculoskeletal discomfort.…”

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confidence: 99%

Effect of chair types on work-related musculoskeletal discomfort during vaginal surgery

Singh

Leon

Morrow

et al. 2016

American Journal of Obstetrics and Gynecology

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“…Many arguments in favor of robotics, in general, are related to surgeon comfort. These include ergonomics with diminished surgeon fatigue, 20,21 issues related to hand dominance, 22 learning curve and skill retention of trainees, 23 and superior visualization with a three‐dimensional view 24 . Comparisons have not been made, however, between laparoscopic and robotic distal pancreatectomy regarding these features.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive distal pancreatectomy and the cost of conversion

Stewart

Wong

Selby

et al. 2020

Journal of Surgical Oncology

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Background Minimally invasive surgery (MIS) is preferred for distal pancreatectomy but is not always attempted due to the risk of conversion to open. We hypothesized that the total cost for MIS converted to open procedures would be comparable to those that started open. Methods A prospectively collected institutional registry (2011‐2017) was reviewed for demographic, clinical, and perioperative cost data for patients undergoing distal pancreatectomy. Results There were 80 patients who underwent distal pancreatectomy: 41 open, 39 MIS (11 laparoscopic and 28 robotic). Conversion to open occurred in 14 of 39 (36%, 3 laparoscopic and 11 robotic). Length of stay was shorter for the MIS completed (6 days; range, 3‐8), and MIS converted to open (7 days; range, 4‐10) groups, compared with open (10 days; range, 5‐36; P = .003). Laparoscopic cases were the least expensive (P = .02). Robotic converted to open procedures had the highest operating room cost. However, the total cost for robotic converted to open cohort was similar to the open cohort due to cost savings associated with a shorter length of stay. Conclusions Despite the higher intraoperative costs of robotic surgery, there is no significant overall financial penalty for conversion to open. Financial considerations should not play a role in selecting a robotic or open approach.

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Comparison of Postural Ergonomics Between Laparoscopic and Robotic Sacrocolpopexy: A Pilot Study

Cited by 78 publications

References 25 publications

Robot‐assisted surgery for the management of apical prolapse: a bi‐centre prospective cohort study

Robot‐assisted surgery for the management of apical prolapse: a bi‐centre prospective cohort study

Effect of chair types on work-related musculoskeletal discomfort during vaginal surgery

Minimally invasive distal pancreatectomy and the cost of conversion

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