R. Boulay

A cost analysis of postoperative management in endometrial cancer patients treated by robotics versus laparoscopic approach

OBJECTIVE The purpose of this study is to compare postoperative pain management and costs in endometrial cancer patients who had a robotic-assisted or laparoscopic-assisted hysterectomy. METHODS This is a retrospective cohort study of all endometrial cancer patients from 9/2005 to 6/2010 who had a completed robotic-assisted or laparoscopic-assisted hysterectomy. All surgeries were performed by gynecologic oncologists on the da Vinci S surgical system. Demographic data, patient-recorded pain scores, pain-management interventions, and postoperative pain medication costs were compared. Data was analyzed using Students t-tests and Pearsons χ(2) tests in SPSS. RESULTS Two-hundred fifteen (101 robotic and 114 laparoscopic) patients met the inclusion criteria. There were no significant differences between the groups in age, BMI, clinical stage, comorbidities, lymph nodes retrieved, and the number of narcotic vs. non-narcotic drug interventions administered. Robotic patients had a lower number of initial drug interventions (21 vs. 52; P<.001) and total drug interventions (162 vs. 219; P<.001) than laparoscopic patients. Robotics had a lower initial pain score (2.1 vs. 3.0; P=.012). There was a 50% reduction in the pain medication cost on the day of surgery for robotic patients (

Using focus groups to identify characteristics of an ideal work environment for Advanced Practice Clinicians.

12.24 vs.

A Comparison of Quality Outcome Measures in Patients Having a Hysterectomy for Benign Disease: Robotic vs. Non-Robotic Approaches

24.45; P<.01), and a 56% cost reduction for the rest of their length of stay (

Factors Associated with Regression of Cervical Dysplasia in Adolescents: A Retrospective Study (Poster)

3.63 vs.

Peri-operative Management of Heparin-Induced Thrombocytopenia Syndrome in a Patient With a Suspected Gynecologic Malignancy

8.17; P<.01). CONCLUSION Endometrial cancer patients who have robotic surgery experience less initial postoperative pain and have fewer drug interventions. The cost associated for their pain management represents a savings of greater than 50%. These factors demonstrate the value of robotic surgery in regard to postoperative pain management by delivering higher quality care at a lower cost.

Comparison of Vaginal Cuff Closure Outcomes in Patients Having Robotic-assisted Total Laparoscopic Hysterectomy: V-Loc vs. Vicryl (Poster)

Advanced Practice Clinicians (APCs) in collaborative practice represent a diverse and valuable group of health care professionals, including nurse practitioners, physician assistants, nurse anesthetists, and nurse midwives. Because these healthcare professionals have been identified as part of the solution to physician shortages, it is critical for health networks to examine and address issues affecting collaborative relationships. We invited our network APCs to participate in focus group sessions to determine both attributes and barriers to an ideal work environment. Four major themes emerged: (1) compensation, (2) network representation, (3) employment structure, and (4) workplace culture. While issues relating to compensation and representation were prevalent, discussions also revealed the importance of relationships and communication. To ensure successful collaboration and, thereby, reduce clinician turnover, leaders must address gaps between the existing and ideal states in structural factors affecting job satisfaction (Themes 1-3) as well as the behavioral factors represented in workplace culture (Theme 4).