Perioperative outcomes of three-port robotically assisted hysterectomy: a continuous series of 53 cases

Abstract

This study evaluated the feasibility and safety of 3-port robotically assisted laparoscopic hysterectomy (RALH), using a consecutive series of women who underwent 3-port RALH in a university hospital. From November 2010 until June 2013 we operated on 53 women, whose mean age was 48.4 ± 7.7 years (range 35-68 years), and mean body mass index was 27.1 ± 5.1 kg/m 2 (range 19.5-42.9 kg/ m 2 ). The indications for hysterectomy were myoma in 31 (58.5 %), adenomyosis in 10 (18.9 %), cervical dysplasia in 4 (7.5 %), neoplasia in 4 (7.5 %), and recurrent polyps or postmenopausal bleeding in the remaining 4 women (7.5 %). We performed total RALH in 50 cases (94.3 %) and subtotal in the others. The median duration of total intervention was 169 min (interquartile range 147.5-206.5 min). The mean weight of the uterus was 209.8 ± 166.6 g (range 36-790 g) and mean estimated blood loss was 72.3 ± 75.9 ml (range 0-300 ml). There were no perioperative complications, in particular no blood transfusions nor conversions to laparotomy. The median hospital stay was 4 days (interquartile range 3-4 days). One patient was reoperated 1 month later for vaginal vault hematoma and another was readmitted 3 weeks post-operatively due to vaginal vault dehiscence after premature intercourse, but did not require reoperation. Three-port RALH is feasible and safe for simple hysterectomy. We believe this experience using minimum ports to be useful to prepare for robotically assisted single-port hysterectomy.

Comparison of Robotic and Laparoscopic Hysterectomy for the Large Uterus

“…Single-port RHs have been described but require more critical evaluation before they can be recommended for routine use. 7 However, Dällenbach 8 describes a 3-port technique in 53 cases of RH as feasible and safe for simple hysterectomy.…”

Three–port robotically assisted laparoscopic hysterectomy (RALH) in case of severe adhesions: A didactic video

“…In addition, women are also concerned by aesthetic results which may be improved by reducing the number of scars. We showed in a previous study that three-port RALH was feasible and safe for simple hysterectomy [5]. We present in a video a three-port robotically assisted laparoscopic hysterectomy (RALH) in case of significant post cesarean adhesions of the vesicouterine fold associated with endometriosis lesions.…”