Risk factors for robotic gynecologic procedures requiring conversion to other surgical procedures. Issue 3 (December 2016)

• Record Type: Journal Article
• Authors: Unger, Cecile A.; Lachiewicz, Mark P.; Ridgeway, Beri
• Is Part Of: International journal of gynaecology and obstetrics. Volume 135:Issue 3(2016:Dec.)
• Page Start: 299
• Page End: 303
• Publication Date: 2016-12
• Subjects: Robotic-assisted laparoscopy -- Robotic hysterectomy -- Robotic surgery; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1016/j.ijgo.2016.06.016
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To determine the incidence of, and risk factors for, conversion from robotic gynecologic procedures to other procedure types. Methods: A retrospective cohort study included data from women who underwent any robotic gynecologic procedures between January 1, 2011 and December 31, 2012 at a tertiary care referral center in the USA. Demographic data, perioperative data, and surgeon experience (monthly case volume) data were retrieved; potential risk factors were compared between robotic procedures that were converted to other procedures and those completed as robotic procedures. Results: There were 942 robotic procedures during the study period. Conversion from robotic to any other type of procedure was recorded for 47 (5.0%, 95% confidence interval 3.8–6.6) procedures and robotic-to-open-surgery conversion occurred in 16 (1.7%, 95% confidence interval 1.0–2.7) procedures. Conversion from robotic surgery to another approach was associated with higher body mass index ( P < 0.001), previous laparotomy ( P = 0.042), and surgeons having a lower monthly robotic surgical case volume ( P = 0.011). Asthma ( P = 0.008), intra-operative bowel injury ( P < 0.001), intra-operative vascular injury ( P = 0.003), and single-port robotic surgery ( P = 0.034) were associated with increased odds of requiring conversion from robotic procedures. Conclusion: The overall incidence of conversion from robotic surgery to laparotomy was low. Higher body mass index, previous laparotomy, history of asthma, using a single-port approach, and surgeon case volume were associated with the risk of conversion.