{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:48:12Z","timestamp":1788878892044,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T00:00:00Z","timestamp":1749859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare robotic (RAL) and open abdominal (OA) hysterectomy for very large uteri in terms of perioperative outcomes, complications, and costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from patients undergoing total hysterectomy between 2015 and 2021 for benign indications with a uterus weighing 1000\u2009g or more according to the pathology report in two French Academic hospitals were retrospectively collected. All patients with a malignant pathology were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 150 patients included, 44 (30%) patients underwent RAL and 106 (70%) underwent OA hysterectomies. Mean uterus weights were 1844\u2009g in the OA group and 1710\u2009g in the RAL group. Mean operative time was longer in the RAL group (217 vs. 124\u2009min;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). No difference was found in terms of intraoperative (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.951) and postoperative complications (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.680). Hospital stay was shorter in the RAL group (1.6 vs. 3.8\u2009days;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The RAL route was more expensive than the OA route regarding operating room occupancy (\u20ac1339 vs. \u20ac2370;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and disposable instruments (\u20ac390 vs. \u20ac654;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001); but cheaper, regarding the cost of hospital stay (\u20ac5042 vs. \u20ac9119;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), which led to a lower global cost with the RAL route (\u20ac8211 vs. \u20ac10\u2009901;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Robotic hysterectomy for uteri weighing more than 1000\u2009g is comparable with open hysterectomy in terms of complications. The robotic approach allows for a shorter hospital stay, which leads to a lower overall cost.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70310","type":"journal-article","created":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T03:59:57Z","timestamp":1749873597000},"page":"1364-1370","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Robotic versus open hysterectomy for very large uterus (more than 1000\u2009g): A bicentric retrospective study of 150 patients"],"prefix":"10.1002","volume":"171","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8084-1182","authenticated-orcid":false,"given":"Thien\u2010Kim","family":"Do","sequence":"first","affiliation":[{"name":"Gynecological Department, Bichat Hospital Assistance Publique des H\u00f4pitaux de Paris (AP\u2010HP)  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pablo","family":"Estevez","sequence":"additional","affiliation":[{"name":"Gynecological Department, Bichat Hospital Assistance Publique des H\u00f4pitaux de Paris (AP\u2010HP)  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffroy","family":"Canlorbe","sequence":"additional","affiliation":[{"name":"Department of Gynecological and Breast Surgery and Oncology, La Piti\u00e9 Salp\u00e9tri\u00e8re Assistance Publique des H\u00f4pitaux de Paris (AP\u2010HP)  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9mentine","family":"Gonthier","sequence":"additional","affiliation":[{"name":"Gynecological Department, Bichat Hospital Assistance Publique des H\u00f4pitaux de Paris (AP\u2010HP)  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Koskas","sequence":"additional","affiliation":[{"name":"Gynecological Department, Bichat Hospital Assistance Publique des H\u00f4pitaux de Paris (AP\u2010HP)  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004679"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.06.015"},{"issue":"8","key":"e_1_2_8_4_1","article-title":"Surgical approach to hysterectomy for benign gynaecological disease","volume":"2015","author":"Aarts JW","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2023.03.024"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17509"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2017.07.005"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2011.03.027"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.4293\/108680810X12785289143837"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2020.00091"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2015.08.003"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.4293\/108680813X13693422521755"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2014.03.010"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-017-0674-4"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogoh.2022.102352"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annfar.2014.07.610"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tracli.2020.08.002"},{"issue":"6","key":"e_1_2_8_19_1","first-page":"540","article-title":"How I do\u2026 A minimally invasive laparoscopic total hysterectomy, with extracorporeal manual tissue extraction in 10 steps (with video)","volume":"47","author":"Gloaguen S","year":"2019","journal-title":"Gyn\u00e9col Obst\u00e9t Fertilit\u00e9 S\u00e9nol"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318265b61a"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.02.008"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2016.00098"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/19.035"},{"issue":"1","key":"e_1_2_8_24_1","first-page":"86","article-title":"Estimation of nongravid uterine volume based on a nomogram of gravid uterine volume: its value in gynecologic uterine abnormalities","volume":"72","author":"Goldstein SR","year":"1988","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1758-5910.2011.00130.x"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16753"}],"container-title":["International Journal of Gynecology &amp; 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