{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T12:43:08Z","timestamp":1794314588821,"version":"4.9.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:00:00Z","timestamp":1666828800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:00:00Z","timestamp":1666828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100017590","name":"Universit\u00e4tsklinikum Essen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017590","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017590","name":"Universit\u00e4tsklinikum Essen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017590","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Minimally invasive (MI) surgery has long been established as a standard for hysterectomy in benign conditions. Robotic surgery is generally seen as equivalent to conventional laparoscopy in terms of patient outcome. However, robotics might facilitate an MI approach even in complex patients, rendering laparotomy unnecessary for almost all patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>We identified 1939 patients who underwent hysterectomy for benign conditions between 2002 and 2020 at the University Hospital of Essen. Peri- and postoperative data as well as patient characteristics were collected retrospectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Robotic surgery, implemented at our institution in 2010, was the most common approach (<jats:italic>n<\/jats:italic>\u2009=\u2009771; 39.8%). 60.2% of all hysterectomies (1168\/1938) were performed using MI techniques. However, there was a significant shift in the methods used for hysterectomy over time. While in 2002 51.4% of all hysterectomies were performed via an open abdominal approach, this percentage dropped to 1.4% in the year 2020. Accordingly, the use of MI approaches increased from 18.9% in 2002 to 98.6% in 2020. The introduction of robotic surgery in 2010 marked a significant shift towards more MI procedures. MI surgery resulted in shorter hospital stay and less postoperative complications compared to laparotomy.<\/jats:p>\n                <jats:p>On a special note, our cohort includes the largest uterus myomatous uterus in the scientific literature with a specimen weight of 54.8\u00a0kg.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our data support the hypothesis that the implementation of robotic surgery leads to an improved capability to perform MI surgery and avoid laparotomy in almost all patients. The known benefits of MI surgery could be confirmed.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00404-022-06821-9","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T05:02:56Z","timestamp":1666846976000},"page":"807-812","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Hysterectomy in benign conditions: a 20-year single-center retrospective on the development of surgical techniques"],"prefix":"10.1007","volume":"307","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0941-5635","authenticated-orcid":false,"given":"Paul","family":"Buderath","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Kimmig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Dominowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawel","family":"Mach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,27]]},"reference":[{"key":"6821_CR1","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/j.amjsurg.2005.05.019","volume":"190","author":"AG Harrell","year":"2005","unstructured":"Harrell AG, Heniford BT (2005) Minimally invasive abdominal surgery: lux et veritas past, present, and future. Am J Surg 190:239\u2013243","journal-title":"Am J Surg"},{"key":"6821_CR2","first-page":"2456","volume":"13","author":"S Haddad","year":"2021","unstructured":"Haddad S, Ghadimi K, Abrishamkar R, Asl NSM (2021) Comparing laparoscopy and laparotomy procedures in the radical hysterectomy surgery for endometrial cancer: a basic review. Am J Transl Res 13:2456\u20132461","journal-title":"Am J Transl Res"},{"key":"6821_CR3","doi-asserted-by":"publisher","unstructured":"Aarts JW, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BW, Kluivers KB (2015) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2015(8):CD003677. https:\/\/doi.org\/10.1002\/14651858.CD003677.pub5","DOI":"10.1002\/14651858.CD003677.pub5"},{"key":"6821_CR4","first-page":"242","volume":"113","author":"KJ Neis","year":"2016","unstructured":"Neis KJ, Zubke W, Fehr M, Romer T, Tamussino K, Nothacker M (2016) Hysterectomy for benign uterine disease. Dtsch Arztebl Int 113:242\u2013249","journal-title":"Dtsch Arztebl Int"},{"key":"6821_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/S0950-3552(97)80047-8","volume":"11","author":"C Sutton","year":"1997","unstructured":"Sutton C (1997) Hysterectomy: a historical perspective. Baillieres Clin Obstet Gynaecol 11:1\u201322","journal-title":"Baillieres Clin Obstet Gynaecol"},{"key":"6821_CR6","doi-asserted-by":"publisher","first-page":"9","DOI":"10.2298\/ACI1104009S","volume":"58","author":"R Sparic","year":"2011","unstructured":"Sparic R, Hudelist G, Berisava M, Gudovic A, Buzadzic S (2011) Hysterectomy throughout history. 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