The increasing use of robot-assisted approach for hysterectomy results in decreasing rates of abdominal hysterectomy and traditional laparoscopic hysterectomy.

Purpose: To compare the frequency of minimally invasive surgical approach to hysterectomy between two time periods, during which the use of the robotic technique has rapidly increased.

Methods: This study is a retrospective review of 623 consecutive patients who underwent hysterectomy for benign indications at the Division of Minimally Invasive Gynecologic Surgery via laparoscopic, robotic, laparotomy, mini-laparotomy and vaginal approaches from July 2004 to June 2010. "Early period" refers to the first 311 patients, and "late period" refers to the remaining 312 patients.

Perioperative outcomes of robotic versus laparoscopic hysterectomy for benign disease.

Background And Objectives: We compared the perioperative outcomes of hysterectomy performed by robotic (RH) versus laparoscopic (LH) routes for benign indications using the Dindo-Clavien scale for classification of the surgical complications.

Methods: Retrospective chart review of all patients who underwent robotic (n=288) and laparoscopic (n=257) hysterectomies by minimally invasive surgeons at the University of Michigan from March 2001 until June 2010.

Results: Age, body mass index, operative time, and estimated blood loss were not statistically different between groups.

Risk factors for postoperative urinary retention after laparoscopic and robotic hysterectomy for benign indications.

Objective: To estimate the occurrence of postoperative urinary retention after traditional laparoscopic and robotic hysterectomy.

Methods: We performed a chart review of all patients who underwent total or supracervical hysterectomy using a laparoscopic (n=253) or robotic approach (n=281) from March 2001 until June 2010 for benign indications at the division for minimally invasive surgery. Urinary retention was defined as the inability to spontaneously void or as incomplete voiding requiring either self-catheterization or Foley catheter replacement in the first postoperative week.

The role of robotic surgery in gynecology.

Purpose Of Review: To discuss the recent experience and feasibility of integrating robot-assisted technology into minimally invasive gynecologic surgery. Current applications in gynecology and their associated outcomes will be analyzed.

Recent Findings: Since the late 1990s, the use of computer-assisted or robotic technology in minimally invasive gynecologic surgery has increased.

Adolescent chronic pelvic pain.

The presentation of chronic pelvic pain in the adolescent can at times be quite daunting. A careful and insightful approach to obtaining the history and physical examination must be implemented while maintaining an appreciation of the various stages of adolescent development. The etiologies can range from gynecologic to nongynecologic causes.

Preliminary experience with robot-assisted laparoscopic myomectomy.

The following retrospective case series evaluated the technique and feasibility of integrating robot-assisted technology in the performance of a laparoscopic myomectomy in order to overcome the limitations of conventional laparoscopy. We attempted 35 robot-assisted laparoscopic myomectomies in a university hospital setting with a conversion rate of 8.6%.

Endoscopic management of leiomyomata.

Prior to the advent of modern minimally invasive surgery techniques, the primary surgical management of symptomatic leiomyomata for women desiring future fertility or uterine conservation was through laparotomy. Today, many cases of intramural and subserous leiomyomata are managed with laparoscopic myomectomy and selected cases of submucosal leiomyomata are managed with hysteroscopic myomectomy. The management of leiomyomata endoscopically is one of the more challenging procedures in minimally invasive surgery and requires a skilled surgeon.