Abstract:
STUDY OBJECTIVE:To perform a cost-minimization analysis comparing robotic-assisted, laparoscopic, and abdominal sacrocolpopexy. DESIGN:Cost-minimization analysis using a micro-costing approach (Canadian Task Force classification III). MEASUREMENTS AND MAIN RESULTS:A decision model was developed to compare the costs (2008 US dollars) of robotic, laparoscopic, and abdominal sacrocolpopexy. Our model included operative time, risk of conversion, risk of transfusion, and length of stay (LOS) for each method. Respective baseline estimates for robotic, laparoscopic, and abdominal sacrocolpopexy procedures included operative time (328, 269, and 170 minutes), conversion (1.4%, 1.8%, and 0%), transfusion (1.4%, 1.8%, 3.8%), and LOS (1.0, 1.8, and 2.7 days). Two models were used, the Robot Existing model, that is, current hospital ownership of a robotic system, and the Robot Purchase model, that is, initial hospital purchase of a robotic system, with purchase and maintenance costs amortized and distributed across robotic procedures. Sensitivity analyses were performed to assess the effect of varying each parameter through its range. For the Robot Existing robot model, robotic sacrocolpopexy was the most expensive, $8508 per procedure compared with laparoscopic sacrocolpopexy at $7353 and abdominal sacrocolpopexy at $5792. Robotic and laparoscopic sacrocolpopexy became cost-equivalent only when robotic operative time was reduced to 149 minutes, robotic disposables costs were reduced to $2132, or laparoscopic disposable costs were increased to $3413. Laparoscopic and abdominal sacrocolpopexy became cost-equivalent only when laparoscopic disposable costs were reduced to $668, mean LOS for abdominal sacrocolpopexy was increased to 5.6 days, or surgeon reimbursement for abdominal sacrocolpopexy exceeded $2213. The addition of robotic purchase and maintenance costs resulted in an incremental increase of $581, $865, and $1724 per procedure when these costs were distributed over 60, 40, and 20 procedures per month, respectively. CONCLUSION:Robotic sacrocolpopexy was more expensive compared with the laparoscopic or abdominal routes under the baseline assumptions.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Judd JP,Siddiqui NY,Barnett JC,Visco AG,Havrilesky LJ,Wu JMdoi
10.1016/j.jmig.2010.03.011subject
Has Abstractpub_date
2010-07-01 00:00:00pages
493-9issue
4eissn
1553-4650issn
1553-4669pii
S1553-4650(10)00124-Xjournal_volume
17pub_type
杂志文章abstract:STUDY OBJECTIVES:To evaluate the efficacy of performing the Essure hysteroscopic sterilization in an office-based setting. DESIGN:Prospective, longitudinal analysis (Canadian Task Force classification II-3). SETTING:University out-patient office. PATIENTS:All patients undergoing permanent sterilization in our outpat...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.11.010
更新日期:2006-03-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the incidence and predictive factors of 30-day surgery-related morbidity and occult precancerous and cancerous conditions for women undergoing risk-reducing surgery. DESIGN:A prospective study (Canadian Task Force classification II-1). SETTING:A gynecologic oncology referral center. PA...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.04.017
更新日期:2017-01-01 00:00:00
abstract::A panel of experts in the field of endometriosis expressed their opinions on management options in a 35-year-old patient desiring pregnancy with a history of previous surgery for endometrioma and bowel obstruction symptoms. Many questions that this paradigmatic patient may pose to the clinician are addressed, and vari...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.01.021
更新日期:2015-05-01 00:00:00
abstract::The rate of venous thromboembolic events (VTEs) including deep venous thrombosis and pulmonary embolism among women undergoing gynecologic surgery is high, particularly for women with a gynecologic malignancy. Current guidelines recommend VTE thrombopropylaxis in the immediate postoperative period for patients undergo...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2013.06.001
更新日期:2013-11-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the safety and short-term outcomes of laparoscopic subtotal hysterectomy using the PK and Lap Loop systems. DESIGN:Prospective observational study (Canadian Task Force classification II-2). SETTING:Princess Royal University and Chelsfield Park Hospitals, Kent, UK. PATIENTS:One hundred wom...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.05.007
更新日期:2005-07-01 00:00:00
abstract:STUDY OBJECTIVE:To identify the characteristics of uterine sarcomas and assess the impact of morcellation on prognosis. DESIGN:Case-control study. (Canadian Task Force classification II-2). SETTING:Hospital Quiron-Dexeus, an academic hospital. PATIENTS:Patients with uterine sarcoma histologically diagnosed and treat...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.05.024
更新日期:2015-09-01 00:00:00
abstract:STUDY OBJECTIVE:Our primary goal was to uncover preoperative and intraoperative risk factors that prevented same-day discharge (SDD) after myomectomy in a setting where SDD was the standard of care. Uncovered predictors would serve to enhance patient counseling and medical optimization before surgery. DESIGN:Single-ce...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.03.022
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the surgical technique and short-term outcomes for 26 cases of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) sacrocolpopexy for the treatment of pelvic organ prolapse (POP). DESIGN:Retrospective case series study (Canadian Task Force classification II-2). SETTING:Ac...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.08.009
更新日期:2019-01-01 00:00:00
abstract::Herein is described the case of a 28-year-old woman in whom uterine artery embolization (UAE) was performed to treat intramural ectopic pregnancy. The intramural ectopic pregnancy was diagnosed at magnetic resonance imaging, which showed a gestational sac surrounded completely by myometrium. The UAE procedure was unco...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.10.005
更新日期:2013-03-01 00:00:00
abstract:STUDY OBJECTIVE:To estimate the effectiveness of unidirectional knotless barbed suture and continuous suture with intracorporeal knots in the repair of uterine wall defects during laparoscopic myomectomy. DESIGN:Randomized clinical study (Canadian Task Force Classification I). SETTING:Single-center study in a univers...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2010.06.007
更新日期:2010-11-01 00:00:00
abstract::Lower limb lymphedema and an accompanying lymphatic fistula (lymphorrhea) occur as complications after gynecologic surgery to treat cancer. Herein, we report the case of a 68-year-old woman who underwent resection and radiotherapy because of uterine cervical cancer (stage 2a) 20 years previously. Left lower limb and p...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.04.005
更新日期:2012-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the feasibility and surgical outcome of a novel technique of endoscopic inguinal lymphadenectomy to treat vulvar cancer. DESIGN:Retrospective analysis performed by a single center over 2 years (Canadian Task Force classification II-2). SETTING:Major university teaching hospital. PATIENTS:...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.06.011
更新日期:2011-09-01 00:00:00
abstract::A 69-year-old woman had a 4-year history of recurrent giant condylomas (Buschke-Lowenstein tumor) in the anal and perianal regions, with extension to the vulva and vagina. After failure of 3 surgical excisions, one of which was radical, the condition was successfully treated using carbon dioxide laser vaporization and...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.05.007
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:This study aimed to compare the risks of intraoperative and postoperative urologic complications after robotic radical hysterectomy (RRH) compared with laparoscopic radical hysterectomy (LRH). DATA SOURCES:We searched Pubmed, EMBASE, and the Cochrane Library for studies published up to March 2019. Related ar...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.jmig.2019.07.008
更新日期:2020-01-01 00:00:00
abstract::Value-based care is quality health care delivered effectively and efficiently. Data registries were created to collect accurate information on patients with enough clinical information to allow for adequate risk adjustment of postoperative outcomes. Because most gynecologic procedures are elective and preference-sensi...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.07.003
更新日期:2015-11-01 00:00:00
abstract::We present the case of a 17-year-old nulliparous woman with a history of obesity (body mass index 36.2 kg/m(2)), type 2 diabetes, and polycystic ovary syndrome, who was diagnosed with grade 1 endometrioid adenocarcinoma without radiological evidence of myometrial invasion or metastatic disease. After failure of a fert...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.03.017
更新日期:2015-07-01 00:00:00
abstract:STUDY OBJECTIVE:To study the effect of robotic surgery on the surgical approach to endometrial cancer in a gynecologic oncology center over a short time. DESIGN:Prospective analysis of patients with early-stage endometrial cancer who underwent robotic surgery. SETTING:Teaching hospital. PATIENTS:Eighty patients who ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.03.013
更新日期:2009-07-01 00:00:00
abstract::In healthcare, the goal of maximizing value by improving the quality of care and lowering costs has been notoriously challenging to achieve. The fee-for-service model in gynecology and other fields has historically promoted the reduction of nonsurgical or minimally invasive approaches in favor of complex, often morbid...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2018.11.013
更新日期:2019-02-01 00:00:00
abstract:STUDY OBJECTIVE:The objective of this study was to describe perioperative outcomes of minimally invasive sacrocolpopexy (MISCP) based on 4 different routes of concurrent hysterectomy: vaginal (VH), laparoscopic-assisted (LAVH), laparoscopic supracervical (LSCH), and total laparoscopic (TLH). DESIGN:This was a retrospe...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.08.010
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate the feasibility of sentinel lymph node (SLN) biopsy using a laparoendoscopic single-site (LESS) approach in endometrial cancer (EC). DESIGN:A step-by-step video demonstration of the surgical procedure (Canadian Task Force Classification III). SETTING:The satisfaction of patients who und...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.10.035
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:Sacrocolpopexy (SCP) has become the standard procedure to correct uterovaginal prolapse in women, but techniques and approaches are not standardized. We report the results of the Austrian Sacrocolpopexy Registry, which aimed to collect data on surgical techniques and perioperative outcomes. DESIGN:The ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.10.020
更新日期:2020-11-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate techniques of ureterolysis during complex laparoscopic hysterectomy. DESIGN:Technical video demonstrating different approaches to ureterolysis for complex benign pathology during laparoscopic hysterectomy (Canadian Task Force classification III). SETTING:Benign gynecology department at ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.05.023
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the effects of hypoxia-inducible factor (HIF) inhibitors, flotation agents, barriers, and a surfactant on pneumoperitoneum-enhanced adhesions in a laparoscopic mouse model. DESIGN:Prospective randomized trial (Canadian Task Force classification I). SETTING:Department of Obstetrics and G...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.04.002
更新日期:2007-09-01 00:00:00
abstract:STUDY OBJECTIVE:To compare perioperative and long-term outcomes related to laparoscopic and open abdominal surgical management of cervical cancer. DESIGN:Propensity-matched comparison of prospectively collected data (Canadian Task Force classification II-1). SETTING:University teaching hospital. PATIENTS:Sixty-five ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.03.018
更新日期:2014-09-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the cost-effectiveness of ultrasound (US)-guided aspiration and ethanol sclerotherapy versus laparoscopic surgery for benign-appearing ovarian endometrioma. DESIGN:Prospective, cohort pilot study. SETTING:Multiple centers, Spain. PATIENTS:Forty patients with suspected ovarian endometrioma ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jmig.2019.08.036
更新日期:2020-01-01 00:00:00
abstract::Excessive opioid use and misuse is a pervasive and growing societal problem, and decreasing the surgical contribution to this epidemic represents an opportunity to improve outcomes. Here we describe patterns of opioid prescription, consumption, and persistent use among women undergoing minimally invasive hysterectomy ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.08.024
更新日期:2019-02-01 00:00:00
abstract::Bleeding in adolescence is a common but, potentially, difficult condition to manage. Adolescents present with unique issues related to their age, involvement of family members, different differential diagnosis when compared to an older populations, and challenges associated with their evaluation and treatment. ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.08.014
更新日期:2008-11-01 00:00:00
abstract:STUDY OBJECTIVE:The identification of less invasive methods with acceptable diagnostic value for evaluating intrauterine abnormalities can improve the satisfaction of patients and physicians. Although hysteroscopy plus biopsy has favorable predictive and diagnostic values, limited studies have evaluated its value, and ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.02.016
更新日期:2020-01-01 00:00:00
abstract::Hernia uterine inguinale is a rare condition often presenting within the first few years of life as an asymptomatic palpable mass in the inguinal/groin area. This type of hernia contains uterine tissue and may contain oviducts, ovaries, and rarely the bladder. We report a case of a woman with a history of pelvic pain,...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.06.008
更新日期:2010-11-01 00:00:00
abstract:STUDY OBJECTIVE:To identify bowel nodule features of deep infiltrating endometriosis (DIE) measured through preoperative ultrasound scanning that influence laparoscopic surgical strategy. DESIGN:A retrospective study. SETTING:Malzoni Clinic-Endoscopica Malzoni Department, Center for Advanced Endoscopic Gynecological ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.08.034
更新日期:2020-01-01 00:00:00