Abstract
Objective
The aim of our medico-economic study was to compare robotic surgery cost with conventional
laparoscopic cost in endometrial and cervical cancer.
Study design
Our study included laparoscopic and robot-assisted procedures (radical hysterectomies
and lymphadenectomies) for endometrial or cervical cancer ever since first using the
Da Vinci® in 2008 within a hospital setting. In the hospital perspective, direct costs were
determined by examining the overall medical pathway for each type of intervention.
Actual costs were calculated for 27 conventional laparoscopic procedures and for 30
robot-assisted procedures including initial cost of the robot and its maintenance.
We estimated the complete medical “overall care” costs by adding the costs of consultations,
surgery and post-operative hospital stay to the costs of any eventual emergency consultation
and/or hospitalisation within the two months that followed surgery. A sensitivity
analysis was performed to evaluate the effects of variable modulations.
Results
For endometrial cancer, surgical procedure cost for robotic-assisted surgery was €7402
compared to €2733 for conventional laparoscopic surgery. When considering overall
medical care, the patient treatment average cost was €6666 for the laparoscopic group
(with an average length of stay of 5.27 days) as compared to €10,816 for robotic group
(with an average hospital stay of 4.60 days), p = 0.39. For cervical cancer, average surgical cost with robotic-assisted surgery was
€8501 compared to conventional laparoscopic surgery at €3239. For cervical cancer,
overall care average cost was €7803 for the laparoscopic group (with an average length
of stay of 5.83 days) as compared to €12,211 for the robotic group (with an average
hospital stay of 4.70 days) p = 0.07. Sensitivity analysis results confirmed the cost overrun with the use of robotic
assisted surgery.
Conclusions
Conventional laparoscopy was less expensive in our institution than robotic-assisted
surgery for the surgery of endometrial (1:2.7) and cervical (1:2.6) cancers. When
considering overall medical care, the use of robotic-assisted surgery was found to
be 1.6 times more expensive than conventional surgery.
Keywords
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Article info
Publication history
Published online: October 07, 2013
Accepted:
September 21,
2013
Received in revised form:
June 5,
2013
Received:
December 17,
2012
Identification
Copyright
© 2013 Published by Elsevier Inc.
