1. Advancing Gynaecological Surgery:
Robotics in Singapore General Hospital (SGH) 2013
Thelma Tembo BSc, Peter Barton‐Smith MBBS MD MRCOG
1. BACKGROUND
4. RESULTS
MIS in major gynaecological surgery has failed to achieve penetration of greater than 15% worldwide despite 25 years since the first laparoscopic hysterectomy.1
As a result many women are still offered unnecessary open surgery.
Through enhanced view, precision and ergonomics, robotics offers more surgeons the opportunity to carry out simple major procedures and for advanced surgeons to achieve improved results in complex cases.
Figure 2: Skin-to-skin operating time (mins)
Intraoperative outcomes:
Estimated blood loss: 243 ml (Range 5-160)
Blood transfusion: 4% (n=2)
Conversion to laparotomy: 2% (n=1)
Post-operative outcomes:
Major Complications: 0%, Readmissions: 0%
2. AIM
To assess perioperative outcomes of major benign robotic gynaecological surgery cases in the newly established programme at SGH.
3. METHODS
Figure 3: Mean hospital stay comparison (days)
A Prospective case series of all women undergoing robotic surgery at SGH from February–December 2013.
5. DISCUSSION
In the USA, the first major adopter of robotics, 76% of malignant hysterectomies and 33% of benign hysterectomies are now performed robotically. This is significantly more than conventional MIS surgery and has resulted in a significant drop in unnecessary open surgery rates. At SGH 83% of major cases presenting to the robotic team were successfully performed by robotic MIS in 2013.
Patient Demographics
50 cases were performed during the time period
Mean age: 42.1 years (range: 24-72)
Mean BMI: (range: )
Mean weight (hysterectomy): 315g (range: )
6.CONCLUSION
SGH performed the most robotic gynaecology cases in Southeast Asia in 2013.
Patient benefits: quicker recovery, lower complication rates, reduced open surgery rates and improved quality of life.
Robotics has delivered significant healthcare improvements to patients, surgeons and the institution.
References:1. National Institute For Health And Clinical Excellence Laparoscopic Techniques For hysterectomy 2007 ed 239