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Fertil Steril. 2008 Oct;90(4):1175-9. Epub 2007 Dec 3.

Robotic tubal anastomosis: surgical technique and cost effectiveness.

Author information

  • 1Department of Obstetrics and Gynecology, the Ohio State University, Columbus, Ohio 43210, USA. dhariavxr@hotmail.com

Abstract

OBJECTIVE:

To evaluate the feasibility of robotic microsurgical tubal anastomosis and compare the results and cost effectiveness with the same procedure performed by laparotomy.

DESIGN:

Prospective cohort study.

SETTING:

University hospital.

PATIENT(S):

Patients with a history of bilateral tubal ligation who desired reversal for future fertility.

INTERVENTION(S):

Tubal anastomoses through either a robotic approach or through a laparotomy.

MAIN OUTCOME MEASURE(S):

Operative times, hospitalization, complications, postoperative patency, clinical outcomes, and the cost per live birth.

RESULT(S):

The mean operative time for robotic anastomoses was statistically significantly greater than open anastomoses (ROBOT 201 minutes; OPEN 155.3 minutes), although hospitalization times were statistically significantly shorter (ROBOT 4 hours; OPEN 34.7 hours). The return to instrumental activities of daily living was accelerated in the patients who had undergone a robotic anastomosis (ROBOT 11.1 days; OPEN 28.1 days). Although this was a small series, the pregnancy rates were comparable between groups (ROBOT 62.5%; OPEN 50%), yet the rate of abnormal pregnancy was higher in the robotic group (ectopic: ROBOT 4, OPEN 1; spontaneous pregnancy loss: ROBOT 2, OPEN 1). The cost per delivery was similar between the groups (ROBOT $92,488.00, OPEN $92,205.90).

CONCLUSION(S):

Robotically assisted laparoscopic microsurgical tubal anastomosis is feasible and cost effective with results that are comparable with the traditional open approach.

PMID:
18054354
[PubMed - indexed for MEDLINE]
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