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Archives of Gynecology and Obstetrics
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Archives of Gynecology and Obstetrics
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Implementation of robotic gynecological surgery in a German University Hospital: patient safety after 110 procedures

Authors: Dimitrios Balafoutas; Achim Wöckel; Christine Wulff; Ralf Joukhadar;

Implementation of robotic gynecological surgery in a German University Hospital: patient safety after 110 procedures

Abstract

Abstract Purpose Robotic surgery represents the latest development in the field of minimally invasive surgery and offers many technical advantages. Despite the higher costs, this novel approach has been applied increasingly in gynecological surgery. Regarding the implementation of a new operative method; however, the most important factor to be aware of is patient safety. In this study, we describe our experience in implementing robotic surgery in a German University Hospital focusing on patient safety after 110 procedures. Methods We performed a retrospective analysis of 110 consecutive robotic procedures performed in the University Hospital of Würzburg between June 2017 and September 2019. During this time, 37 patients were treated for benign general gynecological conditions, 27 patients for gynecological malignancies, and 46 patients for urogynecological conditions. We evaluated patient safety through standardized assessment of intra- and postoperative complications, which were categorized according to the Clavien–Dindo classification. Results No complications were recorded in 90 (81.8%) operations. We observed Clavien–Dindo grade I complications in 8 (7.3%) cases, grade II complications in 5 (4.5%) cases, grade IIIa complications in 1 case (0.9%), and grade IIIb complications in 6 (5.5%) cases. No conversion to laparotomy or blood transfusion was needed. Conclusion Robotic surgery could be implemented for complex gynecological operations without relevant problems and was accompanied by low complication rates.

Country
Germany
Keywords

Adult, ddc:610, Endometriosis, Middle Aged, Hysterectomy, Hospitals, Female [MeSH] ; Implementation ; Aged [MeSH] ; Adult [MeSH] ; Humans [MeSH] ; Retrospective Studies [MeSH] ; General Gynecology ; Middle Aged [MeSH] ; Hospitals [MeSH] ; Polyvinylidene fluoride (PVDF) ; Polyvinyls [MeSH] ; Endometriosis/surgery [MeSH] ; Genital Diseases, Female/surgery [MeSH] ; Patient Safety [MeSH] ; Gynecologic Surgical Procedures/methods [MeSH] ; Germany [MeSH] ; Robotic complications ; Postoperative Complications/etiology [MeSH] ; Salpingectomy/methods [MeSH] ; Robotic Surgical Procedures/methods [MeSH] ; Outcome Assessment, Health Care [MeSH] ; Hysterectomy/methods [MeSH] ; Robotic hysterectomy ; Robotic sacrocolpopexy, Salpingectomy, Gynecologic Surgical Procedures, Postoperative Complications, Robotic Surgical Procedures, Germany, Outcome Assessment, Health Care, Humans, Female, Polyvinyls, Patient Safety, General Gynecology, Genital Diseases, Female, Aged, Retrospective Studies

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    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    5
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
5
Top 10%
Average
Average
Green
hybrid