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).