Cost Comparison of Robotic, Laparoscopic, and Open Radical Prostatectomy for Prostate Cancer

Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

“…Cost studies by Lotan et al, Mouraviev et al, Scales et al, and Bolenz et al specifically compared RALP with ORP and reported higher operative costs with RALP, although comparisons were restricted to the costs of the procedure and the duration of initial hospitalization[40,41,42,43]. Scales et al reported that inpatient costs of RALP are volume dependent and that cost equivalence with ORP is possible at high-volume specialty centers; however, they do not report actual cost data[42].…”

“…Scales et al reported that inpatient costs of RALP are volume dependent and that cost equivalence with ORP is possible at high-volume specialty centers; however, they do not report actual cost data[42]. Bolenz et al found that the median direct cost was more for RALP than for ORP ($6,752 vs. $4,437, p < 0.001)[43]. Economic evaluations of the robotic approach should appropriately account for the da Vinci Surgical System (Intuitive Surgical), which costs approximately U.S.$1.6 million with a maintenance fee of $120,000/year after the first year.…”

“…The average cost of disposables is approximately $1,500 per case. Bolenz and colleagues estimated the additional purchase and maintenance costs of the robot to be almost $2,700 per patient, based on an annual caseload of 126 cases[43]. This additional “robot cost” is likely an overestimate as this number will shrink with time, especially in high-volume centers.…”

Robot-Assisted Radical Prostatectomy

“…The magnification of 10 to 20 times, the excellent degrees of freedom for movement of the instruments and the intuitive handling of the machine are advantages compared with the open or standard laparoscopic approaches (7,27,33,36). Although evidence for better oncological and functional results are still unproven robotic assisted radical prostatectomy (1,3,15,21,26,39) is in many countries now the standard of care for the surgical removal of the prostate (4,6,22). Transfusion rates are lower and return to normal activity is shorter in RARP (5,16,20).…”

Robotic Urological Surgery: State of the Art and Future Perspectives

“…The median direct cost was US$ 6752, US$ 5687, and US$ 4437 for RALP, LRP, and RRP respectively. The most important difference was due to surgical supply and operating room cost (Bolenz et al, 2010). However, the surgical volume may reduce this difference.…”