The operating times for robot-assisted
trachelectomies in a single institution: a
retrospective case series
M. McCarthy, J. Coulter & M. Hewitt
Cork University Maternity Hospital, Cork
Introduction
Trends of decreasing operating times for robot assisted
trachelectomies, associated with a learning curve, have been
described by Persson et al (1)
Trends reported by Persson et al (1)
Operating times for robot-assisted
trachelectomies in CUMH
Operating time in minutes
Trachelectomy with concurrent cerclage is an established fertilitysparing procedure to treat early stage cervical cancer. Robotassisted abdominal trachelectomy is a suitable alternative to the
traditional vaginal approach, offering similar accuracy in terms of
cervical length and more precise placement of the cerclage. Cork
University Maternity Hospital commenced robotic trachelectomies
in 2013.
350
300
250
290
255
200
210
150
183
195
4
5
213
100
50
0
1
2
3
Surgery number
6
Figure 2. Trendline of times for robotic-assisted trachelectomies in CUMH
The mean hospital stay was 1.5 days, including stays of
one night for 3 women and two nights for 3 women. One
woman required readmission within six weeks of
discharge.
RESULTS
Figure 1. Reproduced from Persson et al, Fig 3a
Discussion
Aims and Methods
This study aimed to evaluate the operating times via retrospective
case review of the theatre log books.
Postoperative recovery was assessed via inpatient records,
investigating length of hospital stay and whether
readmission within 6 weeks was required.
Results
Initial Procedure time
290 mins
Most Recent Procedure time
213 mins
Mean Operating Time
224.33 mins
Range
183-290
mins
There was a trend of decreasing operating times with
subsequent surgeries performed, though this has appeared to
plateau even at this early stage.
Mean operating times in our institution were shorter in duration
than those reported by Persson in 2012 (297 minutes, range 242430 minutes). Observable reductions in operating times, and
relative predictability of duration are expected to assist in
theatre planning. Post-surgical recovery in respect of discharge
and readmission is satisfactory and in keeping with desired
outcomes
We also show that with increasing experience surgery times
decrease indicating more efficiency in operating the robot.
References
Persson. J., Imboden, S. Reynisson, P., Anderson, B., Borgefeldt, C, &
Bossmar, T., Reproducibility and accuracy of robot-assisted
laparoscopic fertility sparing
radical trachelectomy, Gynecologic Oncology 127 (2012) 484–488