Baptist Memorial Hospital for Women

INTRODUCTION: Uterine fibroids, associated with pelvic pain, abnormal bleeding, and infertility, occur in over 50% of women. Although both are minimally invasive procedures, robotic procedures have been emphasized over MINI in training programs. Prior studies favor ROBA from a safety aspect; however, few studies have compared this to same-day mini-laparotomy myomectomies. This study sought to determine the safety and costs of MINI versus ROBA. METHODS: Patients who underwent MINI (n=98) at an outpatient surgery center were compared to 89 patients who underwent ROBA myomectomies. All patients had a same-day discharge. We compared mean estimated blood loss, mean operative times, and rate of complications (transfusions, organ injury, readmission). We extrapolated costs using existing literature and local information. Cost estimates included preoperative care, operating room (OR), recovery room, physician, and supply costs. RESULTS: MINI was associated with decreased operative time (97.5 minutes versus 181 minutes with ROBA), decreased time to discharge (210 minutes versus 481 minutes), fewer complications (one transfusion required for MINI, two transfusions for ROBA), and lower associated costs ($4,937 for MINI versus $7,299 with ROBA). There was a nonsignificant increase in estimated blood loss with MINI compared to ROBA. CONCLUSIONS/IMPLICATIONS: MINI myomectomies are a cost-effective, safe alternative to ROBA myomectomies. Using standard OR equipment and traditional surgical skills, MINI had shorter OR times and times to discharge at significantly reduced costs. With the large shift toward ROBA surgeries in recent years, this study determined that MINI remains a safe, cost-effective option for our patients.

In 1956, H. Richard Niebuhr and Daniel D. Williams asserted that to the traditional definition of minister as pastor-preacher must be added teacher, chaplain, missionary, evangelist, counselor, and countless others. What Niebuhr and Williams observed as happening within American churches in general was also true within Baptist churches. Beginning sometime around mid-century, Baptist churches hired staff members to lead and plan their music programs; to work with preschoolers, children, teenagers, college students, and senior adults; and to oversee administration, education, and recreational activities. Around the 1970s, some Baptist churches recognized and publicly identified these staff members as ministers and began ordaining them. Women were among these newly ordained ministers. By the 1980s and 1990s, the number of ordained Baptist women had increased significantly, and the number of recognized ministry positions both inside and outside the church also increased significantly. Women were obviously beneficiaries of the trend of ordaining as ministers those serving in positions other than pastor-preacher, or perhaps women were leading the way and were trendsetters for Baptists. Either way, Baptist women were in the mix in this move toward the broader definition of minister.