{
  "abstract": "This study estimated the impact of robotic-assisted surgery (RAS) versus laparoscopy (LPS) on operating time (OT), length of hospital stay (LOHS), and examined mediation through perioperative factors. A secondary analysis of individual patient data from a retrospective multicenter study was conducted. Women with histologically confirmed stage I endometrial cancer (EC) undergoing hysterectomy between January 2010 and December 2023 were included. After inverse probability of treatment weighting (IPTW), baseline covariates achieved standardized mean differences below 0.10. The IPTW-weighted effect estimate of LPS relative to RAS, interpreted as an adjusted association under the assumption of no unmeasured confounding was, 31.4 min for OT (95% CI: 17.8, 46.2) and 0.93 days for LOHS (95% CI: 0.59, 1.34). Blood loss accounted for 11.3 min (36%) of the OT difference and 0.46 days (49%) of the LOHS difference, while other mediators contributed minimally. Direct effects not explained by the measured mediators accounted for 18.6 min (59%) of the OT difference and 0.43 days (46%) of the LOHS difference. At an annual volume of 100 cases, the IPTW-weighted difference between RAS and LPS corresponded to an estimated difference of approximately 52.4 operating-room hours and 93 inpatient bed-days. RAS was associated with shorter OT and LOHS than LPS after adjustment for measured baseline differences. Reduced intraoperative blood loss explained a substantial proportion of these differences, although a considerable residual effect remained unexplained by measured perioperative mediators. Annual resource utilization difference should be interpreted as an illustrative planning estimate rather than a guaranteed operational saving.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11701-026-04097-8.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gynecologic Oncology, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India",
    "Department of Gynecologic Oncology, Tata Medical Center, Kolkata, India",
    "Department of Gynecologic Oncology and Robotic Surgery, Fortis Memorial Research Institute, Gurugram, India",
    "Department of Gynecologic Oncology and Robotic Surgery, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India",
    "Department of Gynecologic Oncology, Max Super Speciality Hospital, Saket, New Delhi India",
    "Department of Gynecologic Oncology,, Amrita Institute of Medical Sciences and Research Center, Kochi, India",
    "Department of Surgical Oncology, Manipal Hospital, Dwarka, India",
    "Department of Genito Uro Oncology Services, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India",
    "Department of Gynecologic Oncology and Robotic Surgery, Narayana Superspeciality Hospital, Kolkata, India",
    "Department of Gynecologic Oncology and Robotic Surgery, Mazumdar Shaw Medical Center, Bengaluru, India",
    "Department of Gynecologic Surgical Oncology and Robotic Surgery, Manipal Hospital, Dwarka, India",
    "Department of Gynecologic Oncology, Apollo Cancer Center, Chennai, India",
    "Department of Gynecologic Oncology and Women Cancer Initiative, Medica Superspeciality Hospital, Kolkata, India",
    "Department of Obstetrics and Gynecology, Fortis Hospital, Mohali, India",
    "Department of Surgical and Gynecologic Oncology and Robotic Surgery, Aster CMI Hospital, Bengaluru, India",
    "Department of Surgical Oncology, Apollo Cancer Center, Chennai, India",
    "SEREXIA Consultancy Pvt. Ltd, Bangalore, India",
    "Department of Clinical and Medical Affairs, Intuitive Surgical, CA USA",
    "Intuitive Surgical, Signature Building, Embassy Golf Link Business Park, Bengaluru, Karnataka India"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 20,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Vandana Jain"
    },
    {
      "affs": [
        1
      ],
      "name": "Jaydip Bhaumik"
    },
    {
      "affs": [
        2
      ],
      "name": "Rama Joshi"
    },
    {
      "affs": [
        3
      ],
      "name": "Yogesh Kulkarni"
    },
    {
      "affs": [
        4
      ],
      "name": "Kanika B. Modi"
    },
    {
      "affs": [
        5
      ],
      "name": "Priya Bhati"
    },
    {
      "affs": [
        6
      ],
      "name": "Surender Dabas"
    },
    {
      "affs": [
        7
      ],
      "name": "Sudhir Rawal"
    },
    {
      "affs": [
        8
      ],
      "name": "Kaustav Basu"
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    {
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        9
      ],
      "name": "Rohit R. Ranade"
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    {
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        10
      ],
      "name": "Nidhi Nayyar"
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    {
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        11
      ],
      "name": "Priya Kapoor"
    },
    {
      "affs": [
        12
      ],
      "name": "Arunava Roy"
    },
    {
      "affs": [
        13
      ],
      "name": "Swapna Mishra"
    },
    {
      "affs": [
        14
      ],
      "name": "Somashekhar S. P."
    },
    {
      "affs": [
        15
      ],
      "name": "Venkat P."
    },
    {
      "affs": [
        16
      ],
      "name": "Prabhakar Pandey"
    },
    {
      "affs": [
        17
      ],
      "name": "Akhil Dahiya"
    },
    {
      "affs": [
        17
      ],
      "name": "Rajveer Bhaskar"
    },
    {
      "affs": [
        17,
        18
      ],
      "name": "Isha Sharma"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/c3f387w3y01c4.bib",
  "cited_by": 0,
  "doi": "10.1007/s11701-026-04097-8",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13731458/",
  "id": "c3f387w3y01c4",
  "issns": [
    "1863-2483",
    "1863-2491"
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  "landing_url": "https://doi.org/10.1007/s11701-026-04097-8",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
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      "2729|Endometrial and Cervical Cancer Treatments"
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  "openalex": "W7225204036",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s11701-026-04097-8.pdf",
  "pmcid": "PMC13731458",
  "pmid": "42975740",
  "published": "2026-11-03",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/c3f387w3y01c4.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:21:39Z",
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      "source": "pmc",
      "url": "https://doi.org/10.1007/s11701-026-04097-8"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2729|Endometrial and Cervical Cancer Treatments",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Robotic-assisted versus laparoscopic hysterectomy in Stage I endometrial cancer: a real-world causal mediation analysis of operating time and length of hospital stay",
  "title_text": "Robotic-assisted versus laparoscopic hysterectomy in Stage I endometrial cancer: a real-world causal mediation analysis of operating time and length of hospital stay",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:21:39Z",
  "url": "https://research.draconitic.com/paper/c3f387w3y01c4",
  "venue": "Journal of Robotic Surgery",
  "versions": []
}