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Obstet Gynecol. 2012 Apr;119(4):717-24. doi: 10.1097/AOG.0b013e31824c0956.

Outcomes and cost comparisons after introducing a robotics program for endometrial cancer surgery.

Author information

1
Jewish General Hospital, Quebec, Canada.

Abstract

OBJECTIVE:

To evaluate the effect of introducing a robotic program on cost and patient outcome.

METHODS:

This was a prospective evaluation of clinical outcome and cost after introducing a robotics program for the treatment of endometrial cancer and a retrospective comparison to the entire historical cohort.

RESULTS:

Consecutive patients with endometrial cancer who underwent robotic surgery (n=143) were compared with all consecutive patients who underwent surgery (n=160) before robotics. The rate of minimally invasive surgery increased from 17% performed by laparoscopy to 98% performed by robotics in 2 years. The patient characteristics were comparable in both eras, except for a higher body mass index in the robotics era (median 29.8 compared with 27.6; P<.005). Patients undergoing robotics had longer operating times (233 compared with 206 minutes), but fewer adverse events (13% compared with 42%; P<.001), lower estimated median blood loss (50 compared with 200 mL; P<.001), and shorter median hospital stay (1 compared with 5 days; P<.001). The overall hospital costs were significantly lower for robotics compared with the historical group (Can$7,644 compared with Can$10,368 [Canadian dollars]; P<.001) even when acquisition and maintenance cost were included (Can$8,370 compared with Can$10,368; P=.001). Within 2 years after surgery, the short-term recurrence rate appeared lower in the robotics group compared with the historic cohort (11 recurrences compared with 19 recurrences; P<.001).

CONCLUSION:

Introduction of robotics for endometrial cancer surgery increased the proportion of patients benefitting from minimally invasive surgery, improved short-term outcomes, and resulted in lower hospital costs.

LEVEL OF EVIDENCE:

II.

PMID:
22433334
DOI:
10.1097/AOG.0b013e31824c0956
[Indexed for MEDLINE]

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