Gynecology Department, University of Pittsburgh Medical Center, Williamsport, PA.
Philadelphia College of Osteopathic Medicine, Philadelphia, PA.
JSLS. 2023 Jul-Sep;27(3). doi: 10.4293/JSLS.2023.00035.
Robotic surgical technology may obviate the need for an assistant surgeon when performing hysterectomy. In rural communities where physician shortages remain a major barrier to healthcare access, reducing the number of surgeons necessary to complete a hysterectomy would be of significant consequence. We sought to investigate the impact of robotic surgery on both the presence of an assistant surgeon and route of hysterectomy following implementation of a robotic surgery program at a single-site community hospital.
Retrospective chart review of hysterectomies performed before and after implementation of a robotic surgical program. Hysterectomies were classified by presence of an assistant surgeon, and by mode of hysterectomy (abdominal, laparoscopic, robotic, and vaginal). We observed the distribution of outcomes between the two study periods and compared them with the χ test.
Following implementation of a robotic surgical program we observed a statistically significant decrease in the presence of an assistant surgeon at the time of hysterectomy from 86.7% to 29.7%, p ≤ 0.0001. There was also an increase in the percentage of hysterectomies performed by minimally invasive technique from 67.0% to 87.4%, p ≤ 0.0001.
Following implementation of a robotic gynecologic surgery program at a single-site rural community hospital, we observed a reduction in the utilization of an assistant surgeon at time of hysterectomy. Additionally, we observed a significant increase in the rate of minimally invasive hysterectomies performed.
机器人手术技术在进行子宫切除术时可能不需要助手外科医生。在医生短缺仍然是获得医疗保健主要障碍的农村社区，减少完成子宫切除术所需的外科医生数量将具有重要意义。我们试图研究在单站点社区医院实施机器人手术计划后对助手外科医生的存在以及子宫切除术途径的影响。
对实施机器人手术计划前后进行的子宫切除术进行回顾性图表审查。子宫切除术按助手外科医生的存在情况以及子宫切除术的方式（腹部、腹腔镜、机器人和阴道）进行分类。我们观察了两个研究期间的结果分布，并与 χ 检验进行了比较。
在实施机器人手术计划后，我们观察到助手外科医生在子宫切除术中的存在率从 86.7%显著下降到 29.7%，p≤0.0001。微创技术进行的子宫切除术百分比也从 67.0%增加到 87.4%，p≤0.0001。
在单站点农村社区医院实施机器人妇科手术计划后，我们观察到助手外科医生在子宫切除术时的使用率降低。此外，我们观察到微创子宫切除术的比例显著增加。
