An economic analysis of robotic versus laparoscopic surgery for endometrial cancer: Costs, charges and reimbursements to hospitals and professionals

Venkat, Pavithra; Chen, Lee-may; Young‐Lin, Nichole; Kiet, T.; Young, Greg; Amatori, Deborah; Dasverma, Barnali; Yu, Xinhua; Kapp, Daniel S.; Chan, John K.

doi:10.1016/j.ygyno.2011.11.036

Cited by 51 publications

(21 citation statements)

References 15 publications

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“…The surgeon charges for robot and laparoscopy were $6,824 and $6,327, respectively (p=0.033) and the anesthesiologist charges were $4,049 and $2,985, respectively (p=0.001). However, there were no differences in reimbursement to the surgeon (p=0.74) and anesthesiologist (p=0.84) between the two operative approaches [15]. Pellegrino et al believed that the main driver of additional costs is disposable instruments of the robot, which is not compensated by the hospital room costs…”

Section: Discussionmentioning

confidence: 99%

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Cost–benefit analysis of robotic surgery in gynaecological oncology

Iavazzo

Gkegkes

2017

Best Practice & Research Clinical Obstetrics & Gynaecol

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Section: Discussionmentioning

confidence: 99%

“…performed such a subanalysis and revealed that the actual costs, charges, and reimbursements associated with robotic versus laparoscopic approach for endometrial cancer and showed the hospital charges for robotic were higher at $64,266 vs. $55,130 for laparoscopy (p=0.036) [15].…”

Section: Discussionmentioning

confidence: 99%

Cost–benefit analysis of robotic surgery in gynaecological oncology

Iavazzo

Gkegkes

2017

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…Seamon et al [30] noted that the OT is not consistently defined, making it difficult to compare this parameter between robotic surgery and laparoscopy in the face of heterogeneous data involving either a lack of the definition of OT in a given publication or the presence of data collection bias (retrospectively versus prospectively collected data). In another study [15], the OT included the time required to place the laparoscopic ports and uterine manipulator with colpotomy ring as well as the robotic docking time. However, other studies did not include these factors in the definition of OT.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Robotic Surgery with Laparoscopy and Laparotomy for Treatment of Endometrial Cancer: A Meta-Analysis

Ran

Jin

et al. 2014

PLoS ONE

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PurposeTo compare the relative merits among robotic surgery, laparoscopy, and laparotomy for patients with endometrial cancer by conducting a meta-analysis.MethodsThe MEDLINE, Embase, PubMed, Web of Science, and Cochrane Library databases were searched. Studies clearly documenting a comparison between robotic surgery and laparoscopy or between robotic surgery and laparotomy for endometrial cancer were selected. The outcome measures included operating time (OT), number of complications, length of hospital stay (LOHS), estimated blood loss (EBL), number of transfusions, total lymph nodes harvested (TLNH), and number of conversions. Pooled odds ratios and weighted mean differences with 95% confidence intervals were calculated using either a fixed-effects or random-effects model.ResultsTwenty-two studies were included in the meta-analysis. These studies involved a total of 4420 patients, 3403 of whom underwent both robotic surgery and laparoscopy and 1017 of whom underwent both robotic surgery and laparotomy. The EBL (p = 0.01) and number of conversions (p = 0.0008) were significantly lower and the number of complications (p<0.0001) was significantly higher in robotic surgery than in laparoscopy. The OT, LOHS, number of transfusions, and TLNH showed no significant differences between robotic surgery and laparoscopy. The number of complications (p<0.00001), LOHS (p<0.00001), EBL (p<0.00001), and number of transfusions (p = 0.03) were significantly lower and the OT (p<0.00001) was significantly longer in robotic surgery than in laparotomy. The TLNH showed no significant difference between robotic surgery and laparotomy.ConclusionsRobotic surgery is generally safer and more reliable than laparoscopy and laparotomy for patients with endometrial cancer. Robotic surgery is associated with significantly lower EBL than both laparoscopy and laparotomy; fewer conversions but more complications than laparoscopy; and shorter LOHS, fewer complications, and fewer transfusions but a longer OT than laparoscopy. Further studies are required.

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“…Nevertheless, it would be necessary to develop innovative operation concepts that make robotic surgery a viable option in benign disease treatment as well. (1,8). The new technical advancements of the surgery robot may help to extend the use of minimally invasive procedures to complex fields of application that were previously accessible only to laparotomy while utilizing the advantages of the minimally invasive approach.…”

Section: Application In Benign Gynecological Diseasesmentioning

confidence: 99%

Robotic surgery in gynecology

Alkatout

Mettler

Maass

et al. 2016

J Turkish German Gynecol Assoc

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Review 224 Robotic surgery in gynecologyRobotic surgery is a dynamic development for minimally invasive procedures. The specialty of gynecology consistently offers new opportunities for innovative surgical techniques and the advancement of existing therapy approaches (Figure 1). Ever since the American FDA granted approval of the Da Vinci operation robot for gynecological operations in 2005, about three million robotic operations have been performed worldwide. 3500 Da Vinci systems are currently in use: 586 of these in Europe and 77 in Germany (4 th quarter of 2015). According to the figures of Intuitive Surgical, about 600,000 interventions were performed on a worldwide basis in the year 2014, of which 50% were performed in gynecology, approximately 30% in urology, and about 20% in general and chest surgeries. In 2011, the proportion of robotic hysterectomies performed for benign indications in the USA was as high as 27% (1). Currently, we have experience in robotic surgery for the majority of gynecological operations and fields of application. The known advantages of minimally invasive surgery, such as less blood loss, shorter durations of hospital stay, and lower patient morbidity compared to open procedures, have been observed here as well. Better exposure of the operating field by 3D technology and the extension of surgical instruments to 7 degrees of freedom permit the use of minimally invasive surgery, even for complex indications. Robot-assisted manipulation of the instruments permits tremor-free handling and reduces work fatigue for the surgeon, which is very advantageous for the surgeon as well as the patient in long and complex interventions. The possibility of working simultaneously on two parallel consoles shortens the learning curve, reduces complication rates, and facilitates the training of surgeons (2). The advancement of robotic surgery in terms of the Da Vinci Xi permits the variable use of optics in all four trocars (paraaortic lymphadenectomy, omentectomy, or interdisciplinary surgery in the upper abdomen can be performed without re-docking) and ensures markedly greater flexibility due to the optimized geometry of the so-called patient cart. Robotic surgery has been criticized for the fact that it requires the use of larger trocars compared to conventional laparoscopy, and is therefore associated with more numerous and larger cosmetic scars; this is avoided by the smaller trocars now used in robotic surgery (3). The development of the single-site systems signifies further new options for the gynecological surgeon (Figure 2). For instance, freedom of movement is now maximized by the introduction of one or more additional working trocars (4, 5). The low level of postoperative pain appears to be another advantage. It is accompanied by a lesser need for analgesics and even shorter hospital stays compared to traditional laparoscopic surgery. One explanation could be the fact that the abdominal wall need not be used as a counter bearing. The absence of irritation and the advantage of tissue protec...

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An economic analysis of robotic versus laparoscopic surgery for endometrial cancer: Costs, charges and reimbursements to hospitals and professionals

Cited by 51 publications

References 15 publications

Cost–benefit analysis of robotic surgery in gynaecological oncology

Cost–benefit analysis of robotic surgery in gynaecological oncology

Comparison of Robotic Surgery with Laparoscopy and Laparotomy for Treatment of Endometrial Cancer: A Meta-Analysis

Robotic surgery in gynecology

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