A cost analysis of postoperative management in endometrial cancer patients treated by robotics versus laparoscopic approach

Dual-console robotic surgery compared to laparoscopic surgery with respect to surgical outcomes in a gynecologic oncology fellowship program

“…However, one of the limitations to our study is that specific portions of the cases were not recorded and timed for fellow vs. attending procedure completion. Total surgical time was identified as one of the primary endpoints to be consistent with endpoints currently cited in the literature [4,5,15,16]. Although most of these manuscripts do not incorporate fellow training, we felt it would be important to use this consistent endpoint to demonstrate that this technique is feasible in this environment.…”

“…From their multivariate analysis, they found that robotic hysterectomy was more costly ($1,291; (95% CI, $985 to $1,597). Another study by Martino et al evaluated post-operative pain management and costs in endometrial cancer patients who underwent robotic or laparoscopic-assisted hysterectomy [5]. Patients undergoing robotic surgery had a lower initial post-operative pain score, a 50% reduction in pain medication costs on the day of surgery, and a 56% cost reduction for the rest of their stay.…”

“…Boggess et al noted that endometrial cancer staging using a robotic-assisted surgical approach was feasible and preferable over laparoscopic or open techniques [4]. Additional studies have drawn similar conclusions, however most have not accounted for the incorporation of resident and fellow education into robotic surgery [1,[5][6][7].…”

Comparison of Postoperative Period in Patients Having a Robotic-Assisted Total Laparoscopic Hysterectomy and Multi-Port Total Laparoscopic Hysterectomy

“…5 Yine Martino ve ark., robot uygulanan hastalarda postoperatif analjezik ilaç kullanımının daha az ve buna bağlı olarak maliyetin de daha düşük olduğunu göstermişlerdir. 16 Ancak Soliman ve ark., postoperatif morfin tüketi-minin robotik grupta daha düşük bulunmasına rağ-men postoperatif ağrı ve antiemetik kullanımı açısından robotik ve konvansiyonel laparoskopik grup arasında fark olmadığını bildirmişlerdir. 17 Bunun nedenini de ağrı değerlendirmelerinin diğer çalışmalara göre farklı zamanlarda yapılmasıyla açıklamışlardır.…”

Robotic Surgery in Cancer Care: Opportunities and Challenges

“…For example in pancreatic neoplasm: safety and feasibility techniques that leads decrease tissue trauma in malignant disease, preserve of immune function, reduction of malignant recurrence, increase efficacy because of access to proper data (Nigri et al, 2011;van Santvoort et al, 2011). In gynecology oncology: easier and more comprehensive lymph adenectomy and overcoming anatomic barriers to the process of staging for endometrial cancer without increasing patient morbidity (Subramaniam et al, 2010;Cardenas-Goicoechea et al, 2011), decrease in hospital stay that directly related to the cost and fewer drug interventions (Lim et al, 2011;Martino et al, 2011), reduce in operating room times, transfusion rates, poor ergonomics associated with laparoscopy, which leads to surgeon discomfort and risk of chronic musculoskeletal occupational injury particularly during longer procedures, and less complications compared to laparotomy (Seamon et al, 2009;Cardenas-Goicoechea et al, 2011). In bladder cancer: The robotic approach to cystectomy appears to provide acceptable operative, pathological and short-term clinical outcomes, seemingly duplicating the principles and practices of the time tested open surgical technique.…”