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The Extra Cost of Robotic Surgery

Cost comparison among robotic, laparoscopic, and open hysterectomy for endometrial cancer.

Journal: Obstetrics and Gynecology. 2010;116:685-93.

Authors: Barnett JC, Judd JP, Wu JM, Scales CD Jr, Myers ER, Havrilesky LJ.

Study from: Duke University, Durham, North Carolina

Problem: Robotic surgery has recently become popular, although the costs of robotic surgery are thought to be significantly higher than laparoscopic surgery. This study, compares the costs of laparoscopic, abdominal and robotic hysterectomy.

Study: The costs associated with robotic, laparoscopic, and abdominal hysterectomy were compared, including hospital and surgical costs, as well as lost income and caregiver costs (societal costs).

Results: The study calculations, which included hospital costs and societal costs, found that laparoscopic surgery was the least expensive approach. Abdominal surgery was the most expensive and robotic surgery was in between. Robotic surgery cost about $2,500 more per case due to the costs of the robot ($1.75 million), additional time needed for each surgery and the costs of disposable robotic equipment.

Authors’ Conclusions: Laparoscopy is the least expensive surgical approach for hysterectomy. Robotic is less costly than abdominal hysterectomy when the societal costs associated with recovery time are accounted for.

Dr. Parker’s Comments: Robotic surgery is being heavily promoted by the company that makes the robot and by surgeons who have been trained to do robotic surgery. However, it has been fairly clear that the robot is very expensive, the surgeries take longer and the disposable robotic instruments are also very expensive. Many of the gynecologists who have adopted robotic surgery were not accomplished laparoscopic surgeons, but are now able to perform minimally invasive surgery using the robot. While robotic surgery is more expensive than laparoscopic surgery, it is less expensive than abdominal surgery because it still provides a faster recovery and less time away from work and home.

(disclaimer – I have been doing laparoscopic surgery since 1987, and have been trained to do robotic surgery, but have only been performing this surgery for about two years with much fewer cases).

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2 Comments

  1. Posted January 26, 2011 at 12:28 pm | Permalink

    robotic surgery is not affordable nor available for everyone.

  2. Susan Chiang
    Posted January 30, 2011 at 2:36 pm | Permalink

    One of the hospitals providing robotic surgery claims that this system can do myomectomy regardless of the size and location of fibroids. When I finally made an appointment for consultation, the Da Vinci surgeon told me to bank my blood and eggs just in case open myomectomy or even open hysterectomy is needed.

    I am not against robotic surgery, but I also realise that in the extremely complicated circumstances when a robotic sugery fails, it still lies in the experience, skill, and judgement of the surgeon to perform a safe and successful surgery. After all, “the robotic surgical system cannot be programmed, nor can it make decisions on its own.

    My ultimate question for robotic surgery is whether the physician is also capable of handling various unexpected situations during the surgery. If the answer is “No”, it is the “extra cost” or “hidden cost” that I can not afford.

Fibroid Doctor William H. Parker

Dr. William H. Parker is a board-certified Fellow in the American College of Obstetricians and Gynecologists. Dr. Parker is an internationally recognized expert in fibroid surgery and research. Based in Los Angeles, California, he is considered one of the best fibroid surgeons for abdominal and laparoscopic myomectomy in the United States and abroad. He has been chosen for Best Doctors in America and Top Doctors every year beginning in the late 90's.

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