Our Summary

The study compared the complications and costs of two types of surgical methods - laparoscopic and robotic-assisted - used for removing uterine fibroids (non-cancerous growths in the uterus). The researchers looked at data from patients across the United States between 2008 and 2012. They found that more patients underwent these surgeries over time and those who had the robotic surgery were generally older and had more health problems. The results showed that patients who had the robotic surgery were slightly more likely to have complications such as respiratory failure, fever, and bowel obstruction, but were less likely to need blood transfusions. However, the robotic surgery was significantly more expensive, costing on average $10,000 more than the laparoscopic method. The researchers concluded that unless there are specific reasons to use the robotic method, the laparoscopic method should be the first choice due to its lower cost and similar risk of complications.

FAQs

  1. What are the two types of surgical methods compared in the study for removing uterine fibroids?
  2. What were the main differences in complications and costs between laparoscopic and robotic-assisted surgeries?
  3. Which surgical method did the researchers recommend as the first choice for removing uterine fibroids and why?

Doctor’s Tip

A doctor might advise a patient considering a laparoscopic hysterectomy to choose this method over robotic-assisted surgery if there are no specific reasons to use the robotic method. The laparoscopic method is generally less expensive and has similar risks of complications, making it a more cost-effective option for most patients.

Suitable For

Patients who are typically recommended for a laparoscopic hysterectomy include those with uterine fibroids, endometriosis, abnormal bleeding, pelvic pain, or other benign gynecologic conditions. Laparoscopic hysterectomy is often recommended for patients who are looking for a minimally invasive surgical option with faster recovery times, less pain, and shorter hospital stays compared to traditional open surgery. It is also recommended for patients who are good candidates for general anesthesia and have a lower risk of complications during surgery.

Timeline

Before laparoscopic hysterectomy:

  • Patient consults with gynecologist or surgeon to discuss symptoms and treatment options
  • Patient undergoes pre-operative testing and evaluation to determine if they are a candidate for surgery
  • Patient may need to stop certain medications or adjust their diet in preparation for surgery
  • Patient is informed of the risks and benefits of laparoscopic hysterectomy

After laparoscopic hysterectomy:

  • Patient undergoes surgery, which typically lasts 1-2 hours
  • Patient stays in the hospital for 1-2 days for monitoring and recovery
  • Patient may experience pain, bloating, and fatigue in the days following surgery
  • Patient is given instructions for at-home care, including managing pain and incision care
  • Patient follows up with their surgeon for post-operative appointments to monitor healing and address any concerns
  • Patient gradually resumes normal activities and may experience improvements in symptoms such as pelvic pain and abnormal bleeding

What to Ask Your Doctor

  1. What are the benefits of laparoscopic hysterectomy compared to other surgical methods?
  2. What are the potential risks and complications associated with laparoscopic hysterectomy?
  3. How long is the recovery time after a laparoscopic hysterectomy?
  4. Will I have any restrictions or limitations on my activities after the surgery?
  5. What is the success rate of laparoscopic hysterectomy in treating my condition?
  6. Will I need any additional treatments or medications after the surgery?
  7. How experienced are you in performing laparoscopic hysterectomies?
  8. Are there any alternative treatment options available for my condition?
  9. What can I expect during the surgical procedure and the post-operative care?
  10. How much will the laparoscopic hysterectomy cost and will my insurance cover it?

Reference

Authors: Ngan TYT, Zakhari A, Czuzoj-Shulman N, Tulandi T, Abenhaim HA. Journal: J Obstet Gynaecol Can. 2018 Apr;40(4):432-439. doi: 10.1016/j.jogc.2017.08.005. Epub 2017 Oct 12. PMID: 29032064