Total Laparoscopic (S-LPS) versus TELELAP ALF-X Robotic-Assisted Hysterectomy: A Case-Control Study

Study Objective To compare the feasibility and safety of the TELELAP ALF-X system and standard laparoscopy for total hysterectomy to treat patients with benign and early malignant gynecologic disease. Design Single-institution retrospective case-control study (Canadian Task Force classification II-2). Setting Catholic University of the Sacred Heart, Rome, Italy. Patients Between October 2013 and May 2015, 203 women underwent TELELAP-ALF X (group 1) or standard laparoscopic (group 2) total hysterectomy and were enrolled. Interventions Total standard laparoscopy vs TELELAP ALF-X robot-assisted hysterectomy for benign and early malignant gynecologic disease. Measurements and Main Results In group 1, the median age was 55 years (range, 40–79 years), median body mass index (BMI) was 25 kg/m2 (range, 17–38 kg/m2), and 51 patients (58%) had undergone previous abdominal surgery. In the control group, the median age was 55 years (range, 34–90 years), median BMI was 25 kg/m2 (range, 17–41 kg/m2), and 31 patients (27%) had previous abdominal surgery. The median operative time was 147 minutes (range, 58–320 minutes) in group 1 and 80 minutes (range, 22–300 minutes) in group 2 (p = .055). The median estimated blood loss was 57 mL (range, 0–600 mL) in group 1 and 99 mL (range, 0–400 mL) in group 2, with no significant differences between the 2 groups (p = .963). Procedures were successfully performed without conversion in 94.3% of cases in the group 1 and in all cases in group 2. Early postoperative pain was significantly lower in group 2. Conclusion TELELAP ALF-X hysterectomy in patients with benign and early malignant gynecologic disease is feasible and safe, and can be considered a valid option for these patients.