Results:
527217 elective gynaecological procedures were performed in the English NHS (1st April 2006 and 31st March 2018), of which 4384 (0.83%) were performed with robotic assistance (3864 (88%) hysterectomy, 706 (16%) adnexal surgery, 192 (4%) urogynaecological surgery). There was gradual rise in uptake but marked geographical variation. Median (IQR) length of stay (LOS) was 1(1-2) night, laparotomy rate: 0.3% and 30-day emergency readmission rate: 4.7%. LOS was statistically but not clinically different across time. Other outcomes did not differ by year.
Conclusions: Robotic gynaecological procedures is increasingly being used in the English NHS, predominantly for hysterectomy, although overall in small proportions (2.6% in the most recent study year). There was wide geographical variation in robotic uptake across England and overall, outcomes were comparable to those reported in other countries.
Funding: This study was supported by a grant from the National Institute for Health Research (NIHR) Health Services and Delivery Research (HS&DR) Programme (14/70/162).