Cost Analysis of Abdominal, Laparoscopic, and Robotic-Assisted Myomectomies

Behera, Millie A.; Likes, C.E.; Judd, John P.; Barnett, Jason C.; Havrilesky, Laura J.; Wu, Jennifer M.

doi:10.1016/j.jmig.2011.09.007

Cited by 60 publications

(25 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A cost analysis study compared laparotomy, laparoscopic myomectomy, and robot-assisted laparoscopic myomectomy and found that the abdominal approach was less expensive and the robot-assisted laparoscopic myomectomy was the most expensive. However, the robotic costs could approach the costs of the laparoscopic approach if the disposable costs were less than $1,400 U.S. 64 There are several observations from these data. Robotic technology can offer a minimally invasive approach with improved perioperative outcomes compared with laparotomy but at higher costs.…”

Section: Robot-assisted Laparosocpic Myomectomymentioning

confidence: 97%

Surgical Management of Leiomyomas for Fertility or Uterine Preservation

Falcone

Parker

2013

Obstetrics &Amp; Gynecology

114

View full text Add to dashboard Cite

Leiomyomas are the most common pelvic tumors in women. These tumors are not always symptomatic but can cause abnormal uterine bleeding and anemia, pelvic pressure and pain, urinary frequency, and adverse reproductive outcomes-symptoms that can diminish the quality of life of women. Myomectomy is the primary treatment modality for women with symptomatic leiomyomas who are of reproductive age and desire future fertility. Myomectomy can significantly improve symptoms and quality of life and, in some clinical situations, improve reproductive outcomes. There are robust surgical outcome data supporting the use of a minimally invasive approach such as laparoscopy and hysteroscopy over laparotomy. Perioperative outcomes and return to normal activity are significantly better with a minimally invasive approach. Reproductive outcomes are not adversely affected. Detailed preoperative imaging is required for minimally invasive procedures to be successful. There are several evidence-based techniques that can be used to reduce blood loss during surgery. The role of robotic technology in enhancing surgical outcomes has not been clearly defined.

show abstract

Section: Robot-assisted Laparosocpic Myomectomymentioning

confidence: 97%

Surgical Management of Leiomyomas for Fertility or Uterine Preservation

Falcone

Parker

2013

Obstetrics &Amp; Gynecology

114

View full text Add to dashboard Cite

show abstract

“…Depending on the region, a hospital’s productivity, and other factors, the cost of myomectomy via laparotomy vs. laparoscopy with or without robotic-assistance may vary. According to Behera et al [18], robotic myomectomy is associated with significantly higher costs than abdominal and laparoscopic myomectomy. Perioperative costs of abdominal and laparoscopic myomectomy are more similar.…”

Section: Discussionmentioning

confidence: 99%

“…Behera et al [18] and Carls et al [19] determined the perioperative costs of IM myomectomy, inclusive of procedural and inpatient costs of abdominal and laparoscopic myomectomy. Estimated costs were based on charges, and a macro-cost approach determined the market price.…”

Section: Methodsmentioning

confidence: 99%

Is Myomectomy Prior to Assisted Reproductive Technology Cost Effective in Women with Intramural Fibroids?

Ojo-Carons

Armstrong²,

DeCherney³

et al. 2016

Gynecol Obstet Invest

View full text Add to dashboard Cite

Aim: To evaluate the cost effectiveness of surgery to remove intramural (IM) fibroids prior to assisted reproductive technology (ART). Methods: The decision tree mathematical model along with sensitivity analysis was performed to analyze cost effectiveness of: (1) myomectomy followed by ART or (2) ART with IM myoma(s) in situ. Results: At the median ongoing pregnancy (OP) rate (OPR) reported in the literature for a fresh, autologous ART cycle with IM fibroids in situ vs. post-IM myomectomy, average cost per OP was $72,355 vs. 66,075, indicating a cost savings with myomectomy. Sensitivity analysis over the range of reported OPRs demonstrated that pre-ART IM myomectomy was always cost effective when OPR among women with in situ myomas was <15.4%. However, for OPRs ≥15.4%, pre-ART IM myomectomy was only cost effective if it increased OPR by at least 9.6%. At the high end of OPRs reported for patients with IM myomas in situ (31.4%), a 19.5% improvement in OPR was needed to justify IM myomectomy from a cost perspective. Conclusion: Myomectomy should be used sparingly in cases where the goal of surgery is to achieve improvement in the outcomes of ART.

show abstract

“…A Canadian cost analysis comparing abdominal, laparoscopic, and robotic-assisted myomectomy concluded that the abdominal approach was the least expensive [62]. A study comparing laparoscopic myomectomies with open myomectomies demonstrated that the laparoscopic approach was less expensive [63], whereas a study comparing robotic myomectomy vs abdominal myomectomy demonstrated that the robotic technique was more costly [64].…”

Section: Cost Analysismentioning

confidence: 99%

Endoscopic Treatment and Power Morcellation of Uterine Fibroids

Dixit

Jesner

Modarres

2016

Curr Obstet Gynecol Rep

View full text Add to dashboard Cite

Although a variety of pharmacological and radiological treatment options are available, surgery in the form of myomectomy or hysterectomy provides a quick and effective relief of many symptoms, albeit with attendant surgical risks. In this article, we discuss endoscopic surgical treatments, their relative benefits, and their risks, including risk of morcellation. Patient selection and preoperative preparation for various surgical approaches is discussed. Overall, the evidence base for surgical treatments, including endoscopic, is weak, and, therefore, a pragmatic approach is outlined.

show abstract

Cost Analysis of Abdominal, Laparoscopic, and Robotic-Assisted Myomectomies

Cited by 60 publications

References 22 publications

Surgical Management of Leiomyomas for Fertility or Uterine Preservation

Surgical Management of Leiomyomas for Fertility or Uterine Preservation

Is Myomectomy Prior to Assisted Reproductive Technology Cost Effective in Women with Intramural Fibroids?

Endoscopic Treatment and Power Morcellation of Uterine Fibroids

Contact Info

Product

Resources

About