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Comparative analysis of operative time, length of stay in ICU and estimated blood loss in robot-assisted and laparoscopic surgery

Kameliya Todorova Tsvetanova, Maria Atanasova, Borislava Ivova, Latchesar Tanchev



Minimally invasive surgical techniques are increasingly utilized in contemporary surgical practice worldwide. Despite the similarities between them, such as minimal tissue trauma, improved visibility of the operative field, etc.,  there are also a number of differences. The most common of them are related to the operative time and length of stay in the intensive care unit (ICU), as well as the amount of intraoperative blood loss.


The aim of this study is to compare the length of ICU stay, the need for blood transfusion due to intraoperative bleeding and the mean operative time in accordance with the body mass index among Bulgarian female patients, who underwent laparoscopic and robot-assisted gynecological surgery.


We analyzed 460 women with benign and malignant gynecological diseases who were operated on at the Gynecology Clinic at the University Hospital - Pleven, Bulgaria  from 2007 to 2015. Robot-assisted surgery was performed on 223 patients, and laparoscopic surgery - on 247 patients.


We found out that  ICU stay (in days) was 1.12 in the group of robot-assisted operations, and 1.05 - in the laparoscopic surgery group. The operative time in laparoscopic operations was significantly shorter, as compared to robot-assisted operations.


The need for blood transfusion was determined, considering the estimated intraoperative blood loss and the changes of hemoglobin and hematocrit levels in the postoperative period, compared to their preoperative values. Three prognostic groups were formed.


robotic surgery, length of ICU stay, blood transfusion, operative time

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About The Authors

Kameliya Todorova Tsvetanova
Clinic of Anaesthesiology, Resuscitation and Intensive Care, Oncology Center, University Hospital `Georgi Stranski`- Pleven, Bulgaria

Clinic of anaesthesiology, resuscitation and intensive care, Oncology center

Maria Atanasova
Clinic of Anaesthesiology, Resuscitation and Intensive Care, University Hospital `St. Anna`- Sofia, Bulgaria

Clinic of anaesthesiology, resuscitation and intensive care

Borislava Ivova
University hospital `Georgi Stranski`- Pleven, Bulgaria

Clinic of gynecologic oncology

Latchesar Tanchev
University hospital `Georgi Stranski`- Pleven, Bulgaria

Clinic of gynecologic oncology

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