Comparison of Intraoperative and Postoperative Bleeding Risks Between Robot-assisted and Laparoscopic Hysterectomy

Background: This study aimed to compare bleeding risks between robot-assisted and laparoscopic hysterectomy and to provide a guidance for selection of surgical methods to minimize intraoperative bleeding. Methods: We enrolled patients who underwent robotic or laparoscopic hysterectomy at our institu...

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Main Authors: Tae Yeong Kim, So Hee Park, Jae Hong Sang, Jeong In Choi, Soo-Ho Chung
Format: Article
Language:English
Published: IMR Press 2024-05-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/51/5/10.31083/j.ceog5105122
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author Tae Yeong Kim
So Hee Park
Jae Hong Sang
Jeong In Choi
Soo-Ho Chung
author_facet Tae Yeong Kim
So Hee Park
Jae Hong Sang
Jeong In Choi
Soo-Ho Chung
author_sort Tae Yeong Kim
collection DOAJ
description Background: This study aimed to compare bleeding risks between robot-assisted and laparoscopic hysterectomy and to provide a guidance for selection of surgical methods to minimize intraoperative bleeding. Methods: We enrolled patients who underwent robotic or laparoscopic hysterectomy at our institution from January 2021 to December 2022. We compared the percentage decrease in hemoglobin levels from within 1 month prior to surgery to postoperative days 1 and 3; the total Jackson-Pratt (JP) drainage by postoperative day 2 or 3; input/output (I/O) difference which means the subtraction of all output including urine and JP drainage volume from the total input of administered fluids, which implies amounts of blood lost on the day of surgery; and the numbers of patients who required transfusions. We compared patients who underwent robotic and laparoscopic hysterectomy, and subgroups thereof based on the uterine weight and the extent of adhesiolysis. Analyses employed IBM SPSS software. The independent samples t-test was used to compare the various groups. A p-value less than 0.05 was considered statistically significant. Results: Robotic hysterectomy demonstrated superior outcomes in terms of the total JP drainage compared to laparoscopic hysterectomy. However, no significant differences were demonstrated between the two surgical procedures in terms of the percentage decrease in hemoglobin levels from 1 month prior to surgery to postoperative days 1 or 3, or I/O difference on the day of surgery. Notably, only patients who received laparoscopic hysterectomy required blood transfusions. Conclusions: Our results support the hypothesis that robotic hysterectomy is not only similar, but actually superior to laparoscopic hysterectomy in terms of bleeding control. Our findings offer valuable guidance when decisions are made to choose surgical method via collaborative consultations involving a medical team and a patient. In particular, our results are beneficial for patients seeking to minimize bleeding during surgery and for those who are unfamiliar with the differences between robotic and laparoscopic hysterectomy.
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spelling doaj-art-b68ed4dab8df4b8d9b2c4915d6607c6c2025-08-20T03:05:07ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632024-05-0151512210.31083/j.ceog5105122S0390-6663(24)02352-2Comparison of Intraoperative and Postoperative Bleeding Risks Between Robot-assisted and Laparoscopic HysterectomyTae Yeong Kim0So Hee Park1Jae Hong Sang2Jeong In Choi3Soo-Ho Chung4Department of Obstetrics and Gynecology, Soonchunhyang University Bucheon Hospital, 14584 Bucheon-si, Gyeonggi-do, Republic of KoreaDepartment of Obstetrics and Gynecology, Soonchunhyang University Bucheon Hospital, 14584 Bucheon-si, Gyeonggi-do, Republic of KoreaDepartment of Obstetrics and Gynecology, Soonchunhyang University Bucheon Hospital, 14584 Bucheon-si, Gyeonggi-do, Republic of KoreaDepartment of Obstetrics and Gynecology, Soonchunhyang University Bucheon Hospital, 14584 Bucheon-si, Gyeonggi-do, Republic of KoreaDepartment of Obstetrics and Gynecology, Soonchunhyang University Bucheon Hospital, 14584 Bucheon-si, Gyeonggi-do, Republic of KoreaBackground: This study aimed to compare bleeding risks between robot-assisted and laparoscopic hysterectomy and to provide a guidance for selection of surgical methods to minimize intraoperative bleeding. Methods: We enrolled patients who underwent robotic or laparoscopic hysterectomy at our institution from January 2021 to December 2022. We compared the percentage decrease in hemoglobin levels from within 1 month prior to surgery to postoperative days 1 and 3; the total Jackson-Pratt (JP) drainage by postoperative day 2 or 3; input/output (I/O) difference which means the subtraction of all output including urine and JP drainage volume from the total input of administered fluids, which implies amounts of blood lost on the day of surgery; and the numbers of patients who required transfusions. We compared patients who underwent robotic and laparoscopic hysterectomy, and subgroups thereof based on the uterine weight and the extent of adhesiolysis. Analyses employed IBM SPSS software. The independent samples t-test was used to compare the various groups. A p-value less than 0.05 was considered statistically significant. Results: Robotic hysterectomy demonstrated superior outcomes in terms of the total JP drainage compared to laparoscopic hysterectomy. However, no significant differences were demonstrated between the two surgical procedures in terms of the percentage decrease in hemoglobin levels from 1 month prior to surgery to postoperative days 1 or 3, or I/O difference on the day of surgery. Notably, only patients who received laparoscopic hysterectomy required blood transfusions. Conclusions: Our results support the hypothesis that robotic hysterectomy is not only similar, but actually superior to laparoscopic hysterectomy in terms of bleeding control. Our findings offer valuable guidance when decisions are made to choose surgical method via collaborative consultations involving a medical team and a patient. In particular, our results are beneficial for patients seeking to minimize bleeding during surgery and for those who are unfamiliar with the differences between robotic and laparoscopic hysterectomy.https://www.imrpress.com/journal/CEOG/51/5/10.31083/j.ceog5105122gynecologic surgical procedureslaparoscopyrobotic surgical proceduresintraoperative complications
spellingShingle Tae Yeong Kim
So Hee Park
Jae Hong Sang
Jeong In Choi
Soo-Ho Chung
Comparison of Intraoperative and Postoperative Bleeding Risks Between Robot-assisted and Laparoscopic Hysterectomy
Clinical and Experimental Obstetrics & Gynecology
gynecologic surgical procedures
laparoscopy
robotic surgical procedures
intraoperative complications
title Comparison of Intraoperative and Postoperative Bleeding Risks Between Robot-assisted and Laparoscopic Hysterectomy
title_full Comparison of Intraoperative and Postoperative Bleeding Risks Between Robot-assisted and Laparoscopic Hysterectomy
title_fullStr Comparison of Intraoperative and Postoperative Bleeding Risks Between Robot-assisted and Laparoscopic Hysterectomy
title_full_unstemmed Comparison of Intraoperative and Postoperative Bleeding Risks Between Robot-assisted and Laparoscopic Hysterectomy
title_short Comparison of Intraoperative and Postoperative Bleeding Risks Between Robot-assisted and Laparoscopic Hysterectomy
title_sort comparison of intraoperative and postoperative bleeding risks between robot assisted and laparoscopic hysterectomy
topic gynecologic surgical procedures
laparoscopy
robotic surgical procedures
intraoperative complications
url https://www.imrpress.com/journal/CEOG/51/5/10.31083/j.ceog5105122
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