Comparing Robot-Assisted with Conventional Laparoscopic Hysterectomy: Impact on Cost and Clinical Outcomes

Pasic, Resad; Rizzo, John A.; Fang, Hai; Ross, Susan O.; Moore, Matthew; Gunnarsson, Candace

doi:10.1016/j.jmig.2010.06.009

Cited by 131 publications

(121 citation statements)

References 12 publications

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“…Affirming the finding that RH cases cost more, we found that the total cost estimates for RH are consistently higher by $2489 per case (12,15,16). Unfortunately, the greater costs associated with RH were not reflected in improvement in outcomes.…”

Section: Discussionsupporting

confidence: 59%

“…Possibly related to this was a trend towards more postoperative endotracheal intubations. Most studies have consistently demonstrated longer operating times for RH (ranging from 26 to 72 minutes longer) (9-13, 15) and Pasic et al found a similar trend towards pulmonary adverse events (15). We propose that the increased need for postoperative intubation may be due to airway edema and basal atelectasis that may develop during lengthy procedures in steep Trendelenburg positioning, which may make tracheal extubation difficult.…”

Section: Discussionmentioning

confidence: 66%

“…The rapid uptake of robotic-assisted hysterectomy (RH) for benign gynecologic disease has expanded the options for achieving a minimally invasive hysterectomy; however, the available data about its comparative effectiveness has been limited to observational studies and two randomized trials which in total include 148 subjects (8)(9)(10)(11)(12)(13)(14)(15)(16). These studies have demonstrated similar outcomes between RH and conventional laparoscopic hysterectomy (LH) with higher costs for robotic-assisted procedures.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Robotic and Laparoscopic Hysterectomy for Benign Gynecologic Disease

Rosero

Kho

Joshi

et al. 2014

Obstetrical &Amp; Gynecological Survey

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Objective-Utilization of robotically assisted hysterectomy for benign gynecologic conditions is increasing. Using the most recent, available nationwide data, we examined clinical outcomes, safety, and cost of robotic compared to laparoscopic hysterectomy.Methods-Women undergoing robotic or laparoscopic hysterectomy for benign disease were identified from the United States 2009 and 2010 Nationwide Inpatient Sample. Propensity scores derived from a logistic regression model were used to assemble matched cohorts of patients undergoing robotic and laparoscopic hysterectomy. Differences in in-hospital complications, hospital length of stay, and hospital charges were assessed between the matched groups.Results-Of the 804,551 hysterectomies for benign conditions performed in 2009 and 2010, 20.6% were laparoscopic and 5.1% robotically-assisted. Among minimally invasive hysterectomies, the use of robotic hysterectomy increased from 9.5% to 13.6% (P=0.002). In a propensity-matched analysis, the overall complication rates were similar between robotic and laparoscopic hysterectomy (8.80 vs. 8 Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptConclusion-The utilization of robotic hysterectomy has increased. Perioperative outcomes are similar between laparoscopic and robotic hysterectomy, but robotic cases cost substantially more.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Robotic and Laparoscopic Hysterectomy for Benign Gynecologic Disease

Rosero

Kho

Joshi

et al. 2014

Obstetrical &Amp; Gynecological Survey

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show abstract

“…Robot-assisted hysterectomy can be implemented and can be performed quickly by a surgeon with laparoscopic experience [42,43]. Since the expenses and the operating time are far greater than those for conventional laparoscopy, in view of the limited resources, the use of robot-assisted hysterectomy must be decided on a case-by-case basis [44][45][46][47]. Systematic overview articles on robot-assisted hysterectomy With regard to quality of life, Sarlos et al…”

Section: Robot-assisted Hysterectomymentioning

confidence: 99%

Indications and Route of Hysterectomy for Benign Diseases. Guideline of the DGGG, OEGGG and SGGG (S3 Level, AWMF Registry No. 015/070, April 2015)

Neis

Zubke

Römer

et al. 2016

Geburtshilfe Frauenheilkd

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Hintergrund: Offizielle Leitlinie, publiziert und koordiniert von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG), der Österreichischen Gesellschaft für Gynäkologie und Geburtshilfe (OEGGG) und der Schweizerischen Gesellschaft für Gynäkologie und Geburtshilfe (SGGG). Durch die Einführung laparoskopischer Operationen wurde die vaginale und abdominale Hysterektomie um 3 weitere Techniken ergänzt. Um die Indikationsfelder abzugrenzen, wurde die Leitlinie "Indikation und Methodik der Hysterektomie bei benignen Erkrankungen" initiiert. Organerhaltende Therapiealternativen wurden ebenfalls integriert. Methode: Die Leitlinie wurde durch ein repräsentatives Gremium von 26 Experten aus Deutschland, Österreich und der Schweiz unter strukturierter unabhängiger Moderation im Konsens erstellt. Die systematische Literatursuche und-bewertung zu Nutzen und Schaden der Therapiealternativen bei symptomatischem Uterus myomatosus, funktionellen Blutungsstörungen und Adenomyosis sowie ein Vergleich der Hysterektomieverfahren erfolgte bis 06/2014 in der Datenbank MEDLINE mit Fokus auf aggregierter Evidenz. Ergebnisse: Alle Formen der Hysterektomie sind in Studien mit einer hohen Zufriedenheit der Patientinnen verbunden. Der vaginalen Hysterektomie soll gegenüber der abdominellen, wenn möglich, der Vorzug gegeben werden. Ist die vaginale Hysterektomie nicht möglich, sollte die Möglichkeit einer laparoskopischen Hysterektomie geprüft werden. Die abdominale Hysterektomie sollte nur bei gesonderter Indikation durchgeführt werden. Für die organerhaltenden Alternativen wurde ebenfalls ein hoher Zufriedenheitsgrad festgestellt, allerdings können bei Belassen des Uterus Rezidive auftreten.

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“…El aumento del costo es la única aparente desventaja, se explica por el uso limitado de las pinzas robóticas (10 usos) y la "vestimenta" del robot, que es desechable, ambos ítems constituyen el 25% del costo total, cifra que se repite en todos los centros de cirugía robótica (27). Esperamos que en la medida que existan más Da Vinci en nuestro país y en el mundo, los insumos reducirán su costo.…”

Section: Tabla II Histerectomías Totales Laparoscópicas Asistidas Porunclassified

Histerectomía total laparoscópica asistida por robot: Experiencia de Clínica Indisa

S¹,

N²,

F³

et al. 2013

Rev. chil. obstet. ginecol.

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Comparing Robot-Assisted with Conventional Laparoscopic Hysterectomy: Impact on Cost and Clinical Outcomes

Cited by 131 publications

References 12 publications

Comparison of Robotic and Laparoscopic Hysterectomy for Benign Gynecologic Disease

Comparison of Robotic and Laparoscopic Hysterectomy for Benign Gynecologic Disease

Indications and Route of Hysterectomy for Benign Diseases. Guideline of the DGGG, OEGGG and SGGG (S3 Level, AWMF Registry No. 015/070, April 2015)

Histerectomía total laparoscópica asistida por robot: Experiencia de Clínica Indisa

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