Do the clinical benefits of robot-assisted laparoscopic hysterectomy outweigh the costs associated with the technology? Not compared to conventional laparoscopic surgery, according to a new study on the 2 minimally invasive techniques.

In an analysis of more than 36,000 patient records from 358 hospitals, funded by Ethicon Endo-Surgery, researchers found no significant difference in cardiac, neurologic, wound and vascular complications between robotic and non-robotic laparoscopic hysterectomy procedures. In both cases, whether performed outpatient or inpatient, surgical complications were less than 1%.

However, robotic surgery was significantly more expensive than traditional laparoscopic hysterectomy, according to the study results published in the Journal of Minimally Invasive Gynecology. Per-patient costs increased by about $2,667 among inpatients and $1,971 among outpatients when robotic assistance was used. Surgery times also increased with robotic surgery vs. non-robotic surgery: 3.22 hours vs. 2.82 hours for inpatients and 2.99 hours vs. 2.46 hours for outpatients.

Since they found "little clinical differences in perioperative and post-operative events" associated with the 2 techniques and increased per-case costs associated with robotic hysterectomy, the researchers, led by Resad Pasic, MD, PhD, recommend "that further investigation is warranted when considering this technology for routine laparoscopic hysterectomies." Dr. Pasic, a professor at the University of Louisville, is also a speaker for Ethicon Endo-Surgery.

Irene Tsikitas

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