Evidence map›Paper›PMID 32253574›Full record

ArticleJournal of robotic surgery2020

Cost variance across obesity class for women undergoing laparoscopic hysterectomy by high-volume gynecologic surgeons.

Jordan S Klebanoff, Paul Tyan, Moena Nishikawa, Alexandra North, Richard Amdur, Andrew Sparks, Jamil M Kazma, Gaby N Moawad

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of robotic surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Impact of Obesity on Clinical and Financial Outcomes of Minimally Invasive Hysterectomy for Benign Conditions.Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Jordan S KlebanoffDepartment of Obstetrics and Gynecology, The George Washington University Hospital, 2150 Pennsylvania Ave NW, Washington, DC, 20037, USA.
Paul TyanDepartment of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Moena NishikawaThe George Washington University School of Medicine, Washington, DC, USA.
Alexandra NorthThe University of South Carolina Medical School Greenville Campus, Greenville, SC, USA.
Richard AmdurDepartment of Surgery, The George Washington University Hospital, Washington, DC, USA.
Andrew SparksDepartment of Surgery, The George Washington University Hospital, Washington, DC, USA.
Jamil M KazmaDepartment of Obstetrics and Gynecology, The George Washington University Hospital, 2150 Pennsylvania Ave NW, Washington, DC, 20037, USA.
Gaby N MoawadDepartment of Obstetrics and Gynecology, The George Washington University Hospital, 2150 Pennsylvania Ave NW, Washington, DC, 20037, USA. Gnmoawad@gmail.com.
George Washington University Hospital · USGeorge Washington University · USUniversity of North Carolina at Chapel Hill · USUniversity of South Carolina · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Health-care costs are affected by obesity with both the direct and indirect costs of health care increasing as body mass index (BMI) increases. However, one important aspect of obesity that lacks rigorous study is what impact BMI has on direct surgical cost. We performed a retrospective cohort study of women undergoing a laparoscopic hysterectomy at our single academic university center between January 2012 and December 2017. Women were excluded if their surgery was performed by anyone other than those surgeons with subspecialty training in minimally invasive gynecologic surgery (MIGS), if their hysterectomy was performed by a modality other than conventional laparoscopy or with robotic assistance, or if the indication for hysterectomy was related to any gynecologic malignancy. We identified 600 patients who underwent laparoscopic hysterectomy during the study period. Women who underwent robotic hysterectomy, compared to laparoscopic, had a shorter operative time, lower estimated blood loss, and shorter length of stay. Mean direct cost (± standard deviation) for the cohort was $6398.53 ± $2304.67, age was 44.5 ± 7.5 years, and BMI was 32.2 ± 7.6. Direct cost for all laparoscopic hysterectomies was evaluated across the five different BMI quintiles and no significant difference between groups was found. There was no significant difference in direct cost across procedures between obese and non-obese patients (p = 0.62) and this remained true when separated out by surgical modality. However, when evaluating morbidly obese patients, there appears to be a trend toward cost reduction with robotic hysterectomy compared to conventional laparoscopy. It does not appear that BMI has a statistically significant impact on direct cost between robotic-assisted and conventional laparoscopic hysterectomy. However, these findings may be due to surgical proficiency and warrant further investigation among surgeons with lesser volume.

Indexed as

Body Mass IndexHealth Care CostsAdultBlood Loss, SurgicalCohort StudiesFemaleHumansHysterectomyLaparoscopyLength of StayMiddle AgedObesityOperative TimeRobotic Surgical ProceduresCostGynecologyLaparoscopic hysterectomyObesityRobotic surgery

Identifiers

PMID32253574
OpenAlexW3014494936

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.