Topics of Interest

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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