Evaluation of the Introduction of Robotic Technology on Route of Hysterectomy and Complications in the First Year of Use

Objective: We sought to determine the differential rates and complications of hysterectomy type in the year prior to and following the introduction of robotic technology.

Study Design: This was a retrospective chart review of 461 hysterectomies performed from July 2007 through June 2008 (period 1) and July 2008 through June 2009 (period 2) at Virginia Commonwealth University Medical Center.

Results: In all, 199 vs 262 hysterectomies were performed in periods 1 and 2: open, 52.3% vs 43.1%; laparoscopic, 18.1% vs 8.0%; robotic, 2.5% vs 24.8%; and vaginal, 27.4% vs 24.1%, respectively. The increase in robotic hysterectomies in period 2 was associated only with a decline in laparoscopic hysterectomy (P < .0001). Major morbidity by route was 23.04% open, 11/1% vaginal, 7.02% laparoscopic, and 4.29% robotic (P < .0001).

Conclusion: Route of hysterectomy changed significantly after the introduction of robotic technology primarily due to a change in management of pelvic organ prolapse. Open hysterectomy was associated with significantly higher complication rates.