Background: The impact of robotics on benign hysterectomy surgical approach, clinical outcomes, and learning curve is still unclear.
Methods: Review of abdominal, vaginal, laparoscopic, or robotic cases in 156 US hospitals in the Premier Research Database.
Results: Of 289 875 hysterectomies, abdominal cases decreased from 2005-2010 (60-33%) and minimally invasive approaches increased (40-67%). Conversion rates were: 0.04% for vaginal, 2.5% for robotic, and 7.2% for laparoscopy (P < 0.001). Robotic surgery time was longest (3.4 h vs. 2.2 vaginal, 2.5 abdominal, 2.7 laparoscopy, P < 0.001). Robotic complication rate was lowest (14.8% vs. 16.2% vaginal, 18.6% laparoscopy, 28.9% abdominal, P < 0.001). Hospital stay was longer following abdominal surgery (3.5 days vs. 1.8 robotic, 1.9 vaginal, 1.8 laparoscopy, P < 0.001). Robotic surgery times and conversion and complication rates improved with experience (2.8 h, 2%, and 13.9%, respectively), even with increasing complexity.
Conclusions: Robotics was successfully incorporated without jeopardizing patient outcomes and increased the overall use of minimally invasive approaches.
Introduction: Robot-assisted radical prostatectomy (RARP) is the treatment option for localized prostate cancer. It can lead to side effects like erectile dysfunction (ED) and post-prostatectomy urinary incontinence (PPUI). This study aimed to evaluate association between dyadic adjustment, PPUI and ED.
Creating assistive technology for older adults requires a deep understanding of their needs, values and preferences. Human-centred approaches can be used to engage older adults in technology research to help ensure that end solutions are ethically aligned, relevant and responsive to their priorities. However, the value of cocreation is not universally acknowledged.
Introduction: With increased access to gender affirming care, the rate of vaginoplasties in the US has risen rapidly. Although some retrospective studies report high rates of lower urinary tract symptoms (LUTS) after gender affirming vaginoplasty, the type and severity of symptoms has not been well-described. The purpose of this study was to prospectively characterize postoperative changes in lower urinary tract function after robotic peritoneal flap vaginoplasty as measured by the American Urological Association Symptom Index questionnaire (AUASI), Urogenital Distress Inventory 6 (UDI6), and additional measures.
Background: Current literature highlights a gap in precise stroke cost data for Latin America. This study measures the real costs associated with acute ischemic stroke care in Latin America using Time-Driven Activity-Based Costing (TDABC). The findings aim to lay a solid foundation for adopting value-based healthcare (VBHC) strategies in the region.
