Determining Optimal Route of Hysterectomy for Benign Indications: Clinical Decision Tree Algorithm.

ABSTRACT:

Objective

To evaluate practice change after initiation of a robotic surgery program using a clinical algorithm to determine the optimal surgical approach to benign hysterectomy.

Methods

A retrospective postrobot cohort of benign hysterectomies (2009-2013) was identified and the expected surgical route was determined from an algorithm using vaginal access and uterine size as decision tree branches. We excluded the laparoscopic hysterectomy route. A prerobot cohort (2004-2005) was used to evaluate a practice change after the addition of robotic technology (2007). Costs were estimated.

Results

Cohorts were similar in regard to uterine size, vaginal parity, and prior laparotomy history. In the prerobot cohort (n=473), 320 hysterectomies (67.7%) were performed vaginally an

SUBMITTER: Schmitt JJ 

PROVIDER: S-EPMC5217714 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature