scholarly journals Comparison between Robot-Assisted Laparoscopic Hysterectomy and Total Laparoscopic Hysterectomy: A Cohort Study

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Khaled Sakhel ◽  
Armen Kirakosyan ◽  
Suneet Chauhan ◽  
James Lukban ◽  
James Hines
Keyword(s):  
Blood Loss ◽  
Group Versus ◽  
Retrospective Chart Review ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Procedure Time ◽  
Robot Assisted ◽  
Safe Alternative ◽  
Operative Outcomes ◽  
Number Of Patients

Objective. To compare the operative outcomes in patients who underwent robot-assisted total laparoscopic hysterectomy (RLH) versus total laparoscopic hysterectomy (TLH). Study Design. Retrospective chart review. All women who underwent RLH in hospital A and TLH in hospital B by a single surgeon were included. Results. 136 patients were included (73 in the RLH group and 63 in the TLH group). There were no conversions to laparotomy in the RLH group versus 7 (11.1%) in the TLH group (). The mean induction time was significantly greater (by 6 minutes) for RLH, independent of docking time, as compared to TLH (). Total procedure time was significantly less in the RLH group (82 minutes) as compared to TLH (108 minutes) (). Mean blood loss was less for RLH (46 mL) as compared to TLH (114 mL) (). A greater number of patients who underwent RLH were discharged on postoperative day 0 as compared to those receiving TLH (). Conclusion. RLH is a safe alternative to TLH and may offer some operative advantages, including fewer conversions to laparotomy, reduced procedure time, less blood loss, and earlier discharge.

scholarly journals Total laparoscopic hysterectomy (TLH) with endosuturing compared with conventional technique using energy sources

2021 ◽  
Vol 13 (2) ◽  
pp. 149-158
Author(s):  
V. Marwah ◽  
S. Dutta ◽  
S. Kedia ◽  
P. Mittal
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Laparoscopic Hysterectomy ◽  
Conventional Technique ◽  
Total Laparoscopic Hysterectomy ◽  
Surgical Instruments ◽  
Energy Sources ◽  
Operative Outcomes ◽  
Pain Scores ◽  
Group 2

Background: The aim of the study was to demonstrate the technique of total laparoscopic hysterectomy (TLH) with intra-corporeal endosuturing using simple sutures and basic surgical instruments and compare with TLH using electric coagulation equipment i.e. energy sources with regard to operative time, blood loss, postoperative stay and pain scores. Methods: A retrospective study was undertaken, in Max Super Specialty Hospital Saket, from June 2015 to May 2018, which included 586 cases of TLH (for benign gynecological conditions), of which 287 were performed using intra-corporeal endosuturing (Group 1) and 299 were performed using energy sources (Group 2). To avoid bias, baseline matching was done for body mass index (BMI), indications for surgery, size of uterus, previous abdominal surgeries and comorbidities like diabetes and hypertension after which there were 172 patients in each group. Results: The mean age of patients was 48.24 ± 6.76 years. All operative outcomes including operative time (104.1 ± 22.6 vs 107.6 ± 32.6 mins, p=0.25), blood loss (78.9 ± 101.6 vs 99.7 ± 177.6 ml, p=0.19), pain score (2.5 ± 1.3 vs 2.7 ± 1.2, p=0.13) and post-operative stay (2.05 ± 0.2 vs 2.07 ± 0.3 days, p=0.36) were similar between the two groups. Uterine size was the major determinant of operative time and operative blood loss. Conclusion: TLH with intracorporeal endosuturing can be performed safely and gives results comparable with TLH performed using energy sources. Advancement in suturing devices can decrease operative time further and potentially make it easier and more acceptable.

scholarly journals Discharge less than 6 hours after robot-assisted total laparoscopic hysterectomy—is it feasible?

2014 ◽  
Vol 12 (1) ◽  
pp. 77-80 ◽  
Author(s):  
Jakob Graves Rønk Dinesen ◽  
Birgit Hessellund ◽  
Lone Kjeld Petersen
Keyword(s):  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Robot Assisted

scholarly journals Total Laparoscopic Hysterectomy with Prior Uterine Artery Ligation at Its Origin

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Vidyashree Ganesh Poojari ◽  
Vidya Vishwanath Bhat ◽  
Ravishankar Bhat
Keyword(s):  
Blood Loss ◽  
Uterine Artery ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Artery Ligation ◽  
Uterine Arteries ◽  
Uterine Artery Ligation ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

We compared the duration of surgery, blood loss, and complications between patients in whom both uterine arteries were ligated at the beginning of total laparoscopic hysterectomy (TLH) and patients in whom ligation was done after cornual pedicle. Using a prospective study in a gynecologic laparoscopic center, a total of 52 women who underwent TLH from June 2013 to January 2014 were assigned into two groups. In group A, uterine arteries were ligated after the cornual pedicles as done conventionally. In group B, TLH was done by ligating both uterine arteries at the beginning of the procedure. All the other pedicles were desiccated using harmonic scalpel or bipolar diathermy. Uterus with cervix was removed vaginally or by morcellation. The indication for TLH was predominantly dysfunctional uterine bleeding and myomas in both groups. In group A, the average duration of surgery was 71 minutes, when compared to 60 minutes in group B(P<0.001). In group A, the total blood loss was 70 mL, when compared to 43#x2009;mL in group B (Pvalue < 0.001). There were no major complications in both groups. To conclude, prior uterine artery ligation at its origin during TLH reduces the blood loss and surgical duration as well as the complications during surgery.

scholarly journals Gynecologists May Underestimate the Amount of Blood Loss during Total Laparoscopic Hysterectomy

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Masakazu Sato ◽  
Minako Koizumi ◽  
Kei Inaba ◽  
Yu Takahashi ◽  
Natsuki Nagashima ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Laboratory Testing ◽  
Ovarian Tumor ◽  
Open Surgery ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Before And After

Background. We considered the possibility of underestimation of the amount of bleeding during laparoscopic surgery, and we investigated comparing the amount of bleeding between laparoscopic surgery and open surgery by considering the concentration of hemoglobin before and after surgery as indicators. Methods. The following procedures were included: A, surgery for ovarian tumor; B, myomectomy; and C, hysterectomy either by laparoscopic surgery or open surgery. Patients who underwent the above procedures in between January 1, 2010, and December 31, 2017, were enrolled. We identified 1749 cases (A: 90, B: 105, and C: 325 of open surgery and A: 667, B: 437, and C: 125 of laparoscopic surgery). We considered the sum as an estimation of blood loss during surgery and the change in the value of hemoglobin in laboratory testing one day before and after surgery. Results. During laparoscopic surgery, the measurements of blood loss included the following: A: 59.8 ml; B: 168.6 ml; and C: 206.8 ml. During open surgery, measurements of blood loss included the following: A: 130.7 ml; B: 236.7 ml; and C; 280.9 ml. The reduction of hemoglobin after surgery compared with that before surgery was less in laparoscopic surgery than that in open surgery in A and B; however, this reduction was not significantly different in C. Conclusion. Our results suggest that the estimation of the bleeding in A and B was appropriate; however, the estimation might be underestimated in C during laparoscopic surgery.

scholarly journals Comparison between Laparoscopic Hysterectomy and Abdominal Hysterectomy

2014 ◽  
Vol 9 (1) ◽  
pp. 26-28
Author(s):  
R Shrestha ◽  
LH Yu
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Short Hospital Stay ◽  
Early Recovery ◽  
Duration Of Hospital Stay ◽  
Operative Recovery

Aims: Hysterectomy can be performed by abdominal, vaginal and laparoscopic methods. Laparoscopic hysterectomy has been reported as an alternative to traditional abdominal hysterectomy with benefit of early recovery, short hospital stay and less operative complications. This study compared laparoscopic versus abdominal hysterectomy in terms of surgery time, blood loss, post-operative recovery, and duration of hospital stay. Methods: This is a retrospective comparative study among sixty patients who underwent laparoscopic or abdominal hysterectomy for various indications in the Department of Obstetrics and Gynaecology of the Third affiliated hospital of Zhengzhou University from January to March 2007. The data of the patients meeting the set criteria were obtained from the hospital records and hospital based computerized coding system. Enrolled cases were divided in two groups with thirty in each arm. Group TLH (total laparoscopic hysterectomy) was designated for patients who underwent total laparoscopic hysterectomy and group TAH (total abdominal hysterectomy) for those who underwent total abdominal hysterectomy. Results: There was comparatively less blood loss in TLH group (60.2±5.17 ml versus 75.7±7.12 ml) but it was statistically insignificant (p=0.12). The laparoscopic hysterectomy took longer time (107.6±32.4 min versus 74.9±31.1 min) than the abdominal (p<0.001). There was early recovery among TLH group 1.6±0.6 days versus 2.1±0.5 days in TAH group (p=0.001). Mean duration of hospital stay was significantly shorter in TLH group 7.6±1.9 days versus 10.1±2.1 days in TAH group (p<0.001). Conclusions: Laparoscopic hyserectomy is an effective alternative to abdominal hysterectomy with the advantage of less intra-operative blood loss, fast recovery and short hospital stay. DOI: http://dx.doi.org/10.3126/njog.v9i1.11183 NJOG 2014 Jan-Jun; 2(1):26-28

Robotic and Laparoscopic Approaches for Adrenal Surgery in Obese Patients

2020 ◽  
pp. 000313482095149
Author(s):  
Hosam Shalaby ◽  
Mohamed Abdelgawad ◽  
Mahmoud Omar, MD ◽  
Ghassan Zora, MD ◽  
Saad Alawwad ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operative Time ◽  
Laparoscopic Approach ◽  
Obese Patients ◽  
Adrenal Surgery ◽  
Robotic Approach ◽  
Robot Assisted ◽  
Operative Outcomes ◽  
Estimated Blood Loss

Objective Minimally invasive adrenalectomy is a challenging procedure in obese patients. Few recent studies have advocated against robot-assisted adrenalectomy, particularly in obese patients. This study aims to compare operative outcomes between the robotic and laparoscopic adrenalectomy, particularly in obese patients. Materials and Methods A retrospective analysis was performed on all consecutive patients undergoing adrenalectomy for benign disease by a single surgeon using either a laparoscopic or robotic approach. Adrenal surgeries for adrenal cancer were excluded. Demographics, operative time, length of hospital stays, estimated blood loss (EBL), and intraoperative and postoperative complications were evaluated. Patients were divided into 2 groups; obese and nonobese. A sub-analysis was performed comparing robotic and laparoscopic approaches in obese and nonobese patients. Results Out of 120, 55 (45.83%) were obese (body mass index ≥ 30 kg/m2). 14 (25.45%) of the obese patients underwent a laparoscopic approach, and 41 (74.55%) underwent a robotic approach. Operative times were longer in the obese vs. nonobese groups (173.30 ± 72.90 minutes and 148.20 ± 61.68 minutes, P = .04) and were associated with less EBL (53.77 ± 82.48 vs. 101.30 ± 122, P = .01). The robotic approach required a longer operative time when compared to the laparoscopic approach (187 ± 72.42 minutes vs. 126.60 ± 54.55 minutes, P = .0102) in the obese but was associated with less blood loss (29.02 ± 51.05 mL vs. 138.30 ± 112.20 mL, P < .01) and shorter hospital stay (1.73 ± 1.23 days vs. 3.17 ± 1.27 days, P < .001). Conclusion Robot-assisted adrenal surgery is safe in obese patients and appears to be longer; however, it provides improvements in postoperative outcomes, including EBL and shorter hospital stay.

78 A Retrospective Review of Contact Burns Occurring over the Past Five Years and the Impact of Daily High Temperatures

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S54-S54
Author(s):  
Kevin N Foster ◽  
Tiffany Hockenberry ◽  
Derek Murray ◽  
Karen J Richey
Keyword(s):  
High Temperatures ◽  
External Surface ◽  
Group Versus ◽  
Retrospective Chart Review ◽  
Climate Data ◽  
Burn Center ◽  
Number Of Patients ◽  
June July ◽  
Hot Surface ◽  
The Impact

Abstract Introduction Thermal burns as a result of contact with a hot surface are a frequent cause of injury. A unique subset of contact burns are those sustained as a result of exposure to a hot surface during summer days in geographic areas with excessive ambient temperatures. Under these conditions, external surface temperatures can reach 180 degrees Fahrenheit, and deep cutaneous burns can happen with only a brief contact. Often exposure occurs in patients with impairments that prevent them from removing themselves from such contact in an expeditious fashion leading to severe injury. The purpose of this study was to review and analyze patients admitted to a southwest burn center with burns caused by contact with a hot external surface during the summertime months. Methods This was a retrospective chart review of patients admitted to our regional burn center over a 6-year period, whose burns were sustained from contact with the ground during the months of June, July, and August. Patients were stratified into two groups those whose injuries occurred from 2015 – 2019 and those that occurred in 2020. Climate data was collected from the National Oceanic and Atmospheric Administration website. Results The mean high daily temperature for June, July, and August 2020 was 108.5oF compared to 106.3oF for June, July and August of the preceding five years 2015 to 2019 (p &lt; 0.0001) The number of days during this 3-month period with high temperatures exceeding 110oF was 48 for 2020 compared to a mean of 24 for years 2015 to 2019 (p &lt; 0.0001). Correspondingly, there were 104 inpatient admissions for contact burns during this 3-month period in 2020 compared to a mean of 70 patients each year for 2015 to 2019, a 49% increase. There was no difference in age, gender, % TBSA burned, length of stay, or comorbidities in the two groups of patients. There were differences noted in the ethnicity compositions between the two groups. While alcohol use was not different between the two groups, the admission blood alcohol level was significantly greater in the 2020 group versus the 2015–2019 group (p=.0477). Additionally, the 2020 group demonstrated significantly greater illicit drug use than the 2015 to 2019 group (p.0098). Conclusions This study shows that increasing summertime temperatures in the southwest USA results in a corresponding increase in the number of patients with hot surface contact burns, and this increase is also associated with significantly great drug and alcohol abuse.

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