Robotic surgery in gynecology: program initiation and early outcomes at a community hospital

In 2005, the U.S. Food and Drug Administration (FDA) approved the use of the da Vinci robotic surgical system. This resulted in significant changes in gynecologic surgery. The da Vinci system has improved patient care by reducing the risk of complications associated with surgical intervention and decreasing the length of hospital stays. This study is a retrospective review of the first 215 cases in which the da Vinci surgical technology was implemented in a community hospital. The majority of procedures performed were total abdominal hysterectomies with or without salpingo-oophrectomy. The results were profoundly supportive of the benefits of using the da Vinci system for gynecologic surgery. Of the 215 procedures, only five converted to open, yielding a conversion rate of 2.33%; zero mortalities were incurred. Over three-quarters of the case group experienced an average hospital stay of one day, with an overall complication rate of 7.44%. Early postoperative complications included UTI, urinary retention, vaginal bleeding, small bowel obstruction and port site dehiscence. Overall, the case group results suggest that robotic surgery improved patient care, and potentially allowed surgeons to have better visualization and tissue manipulation during surgery.