Jul 22 2014
A study published in the current issue of the Interactive Journal of Medical Research (i-JMR) reveals that women who had a da Vinci robotic-assisted hysterectomy reported greater satisfaction than women whose surgeons used other approaches, including open, vaginal and laparoscopic hysterectomies.
The study found that women's satisfaction with hysterectomy surgery has generally improved over time, and that women who had da Vinci Hysterectomy reported the greatest overall satisfaction and willingness to recommend and choose the same type of surgery again.
"Previous research shows that compared with open surgery, minimally invasive surgery, including robotic-assisted surgery, can lower health care spending and reduce work absenteeism," said study lead author Michael Pitter, M.D., Chief of Minimally Invasive and Gynecologic Robotic Surgery at Newark Beth Israel Medical Center. "Results from our survey reinforce the importance of patient satisfaction and time to return to normal activities when evaluating the cost-benefit of different surgical approaches."
The study authors identified 114,116 potential survey participants from HysterSisters, an online community comprised of approximately 300,000 registered users who share support and resources for hysterectomy. Members were invited to complete a survey designed to identify key outcomes after surgery, along with socio-demographic characteristics. These included history of prior surgery, type of hysterectomy performed, when the surgery was performed and recovery time. The survey measured women's satisfaction with their procedure in terms of the level of pain and discomfort they experienced, and the reported time it took respondents to return to normal activities, such as walking, driving and work. In addition, women reported whether they would recommend the type of surgery they had to others.
In total, 9,177 women completed the survey. The study then focused specifically on the 6,262 U.S. respondents who had a hysterectomy for a non-cancerous condition and who specified the surgical approach used. Women who had robotic-assisted surgery reported significantly higher overall satisfaction, were more likely to recommend the approach to others and more likely to choose robotic-assisted surgery again. Those who had open hysterectomy were less likely or unlikely to recommend the same approach and less likely to choose the same approach again. Results also showed that between 2001 and 2013, rates of open surgery for hysterectomy decreased by 64 percent. During the same period, robotic-assisted surgery rates rose from zero use to more than one-third of all hysterectomies performed.
To minimize potential for bias, the authors obtained data from women who had surgery at many different hospitals, performed by many different surgeons across the U.S. In their analysis, they controlled for differences across socio-economic groups that could affect study results. The study authors did not collect data on patients' self-reported clinical outcomes.
The study's lead author, Dr. Pitter, is a paid proctor for Intuitive Surgical, Inc. Co-author Christopher Simmonds was the Senior Director of Marketing Services at Intuitive Surgical during this study. Co-author Usha Seshadri-Kreaden is the Principal Biostatistician at Intuitive Surgical. Co-author Helen Hubert, M.P.H., Ph.D., is a paid consultant to Intuitive Surgical in epidemiology.
Hysterectomy, or surgical removal of the uterus, is most often performed for benign conditions including non-cancerous tumors, pelvic pain and abnormal uterine bleeding. In the United States, hysterectomy is the second most common surgery among women. Potential risks of any hysterectomy procedure include but are not limited to: separation of the vaginal incision, blocked lung artery and urinary tract injury.