Fertility and sterility · 2007
Robotic tubal anastomosis: surgical technique and cost effectiveness.
Контролируемое клиническое исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Dharia Patel Sejal P, Steinkampf Michael P, Whitten Scott J, Malizia Beth A
Аннотация
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): Tubal 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.
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): Tubal 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.