Introduction of a computer-based surgical platform in the surgical care of patients with newly diagnosed uterine cancer: Outcomes and impact on approach

Leitao, Mario M.; Briscoe, Gabriel; Santos, Kevin; Winder, Abigail; Jewell, Elizabeth L.; Hoskins, William J.; Dennis, S.; Abu‐Rustum, Nadeem R.; Sonoda, Yukio; Brown, Carol L.; Levine, Douglas A.; Barakat, Richard R.; Gardner, Ginger J.

doi:10.1016/j.ygyno.2012.01.046

Cited by 28 publications

(24 citation statements)

References 21 publications

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“…Leitao et al showed that the ORT was similar in CLS and RALS, among various surgeons, following a learning curve of 40 cases [31]. In contrast, despite our surgeon being past the learning curve, we found a higher ORT in the RALS group.…”

Section: Journal Of Adenocarcinoma Issn 2572-309xcontrasting

confidence: 71%

Perioperative Outcomes in Robotic-Assisted Versus Conventional Laparoscopic Treatment of Endometrial Cancer

Nezhat¹,

Apostol²,

Vega³

et al. 2016

J Adenocarcinoma

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Section: Journal Of Adenocarcinoma Issn 2572-309xcontrasting

confidence: 71%

Perioperative Outcomes in Robotic-Assisted Versus Conventional Laparoscopic Treatment of Endometrial Cancer

Nezhat¹,

Apostol²,

Vega³

et al. 2016

J Adenocarcinoma

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“…The choice of approach was surgeon dependent, the most common reasons for planned laparotomy being obesity and uterine anatomy, accounting for more than half of the laparotomy cases. Additional details are described in a previous publication (12). Tumor histologies and grades were similar (12).…”

Section: Resultsmentioning

confidence: 99%

“…Modeling was then performed to estimate the mean cost of surgical care for patients presenting to our institution for newly diagnosed uterine cancer based on the rate distribution of planned laparoscopy, robotic, and laparotomy from 2007 to 2010, which we have previously published (12). This model was created by calculating weighted projections of total endometrial surgical cost on retrospective case data.…”

Section: Methodsmentioning

confidence: 99%

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Cost-Effectiveness Analysis of Robotically Assisted Laparoscopy for Newly Diagnosed Uterine Cancers

Leitao

Bartashnik

Wagner

et al. 2014

Obstetrics &Amp; Gynecology

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Objective We assessed the direct costs of 3 surgical approaches in uterine cancer and the cost impact of incorporating robot-assisted surgery. Methods A cost system that allocates the actual cost of resources used to treat each patient, as opposed to borrowing cost data from a billing system, was used to determine direct costs for patients who underwent surgery for uterine cancer from 2009–2010. These costs included all aspects of surgical care up to 6 months after discharge. Total amortized direct costs (AC) included the capital cost of 3 dual console DaVinci Si platforms with 5 years of service contracts. Non-amortized costs (NAC) were also calculated (excluded capital costs). Modeling was performed to estimate the mean cost of surgical care for patients presenting with endometrial cancer from 2007–2010 Results Of 436 cases (132 laparoscopic, 262 robotic, 42 laparotomy), total mean AC/case was $20,489 (laparoscopy), $23,646 (robot), and $24,642 (laparotomy) (P<0.05 [robot vs laparoscopy]; P=0.6 [robot vs laparotomy]). Total NAC/case was $20,289, $20,467, and $24,433, respectively (P=0.9 [robot vs laparoscopy]; P=0.03 [robot vs laparotomy]). The planned surgical approach in 2007 was laparoscopy-68%, robot-8%, and laparotomy-24% compared to 26%, 64%, and 9%, respectively, in 2010 (P<0.001). The modeled mean AC/case was $21,738 in 2007 and $22,678 in 2010 (+$940). NAC was $21,298 in 2007 and $20,573 in 2010 (−$725). Conclusion Laparoscopy is least expensive when including capital acquisition costs. Laparoscopy and robotic surgery are comparable if upfront costs are excluded. There is cost neutralization with the robot when it helps decrease laparotomy rates.

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“…al [39]. Endometrial cancer (n = 649); laparoscopically assisted vaginal hysterectomy (n = 229), total laparoscopic hysterectomy (n = 338), trachelectomy (n = 2), other (n = 4); robotic arm (n = 347) versus laparoscopic arm (al [31].…”

mentioning

confidence: 99%

Robotic-Assisted Pelvic and High Para-aortic Lymphadenectomy (RPLND) for Endometrial Cancer and Learning Curve

Jacob

Somashekhar

Jaka

et al. 2016

Indian J Gynecol Oncolog

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Purpose and Objectives The present prospective non-randomized observational study was designed to analyse the learning curve for robotic-assisted pelvic and high paraaortic lymphadenectomy for endometrial cancer patients. Materials and Methods Between 2011 and 2013, 131 consecutive endometrial cancer patients underwent type-1 extrafascial pan hysterectomy with pelvic and high paraaortic lymphadenectomy using the daVinci Ò robotic surgical procedures at single quaternary care Indian cancer institution. For lymph nodes retrieval data, the point at which as per AJCC-TNM staging, time taken to reach, recommended minimum number of lymph nodes at each segment of pelvic and para-aortic lymphadenectomy was plotted and analysed. Data were analysed for the number of lymph nodes retrieved in pelvic and high para-aortic lymphadenectomy specimen. The surgery was performed by the same surgeon in all cases. Results Target number of pelvic lymph nodes 12 was achieved by ninth case, and consistently, more number of pelvic nodes were removed. Target number of para-aortic lymph nodes 10 was achieved at eighteenth case. Conclusion In our study, adequate number of pelvic lymph nodes retrieval of 12 was achieved by ninth case, and consistently, more number of pelvic nodes were removed and para-aortic lymph nodes retrieval of 10 was after eighteenth case. Our study confirms the proficiency and efficiency of robotic surgical approach in treatment of endometrial cancer, with adequate lymph node retrieval, and offers a safe and useful alternative to conventional surgical techniques with shorter learning curve.

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Introduction of a computer-based surgical platform in the surgical care of patients with newly diagnosed uterine cancer: Outcomes and impact on approach

Cited by 28 publications

References 21 publications

Perioperative Outcomes in Robotic-Assisted Versus Conventional Laparoscopic Treatment of Endometrial Cancer

Perioperative Outcomes in Robotic-Assisted Versus Conventional Laparoscopic Treatment of Endometrial Cancer

Cost-Effectiveness Analysis of Robotically Assisted Laparoscopy for Newly Diagnosed Uterine Cancers

Robotic-Assisted Pelvic and High Para-aortic Lymphadenectomy (RPLND) for Endometrial Cancer and Learning Curve

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