Direct cost of hysterectomy: comparison of robotic versus other routes

Kaaki, Bilal; Lewis, Emma; Takallapally, Sukruta; Cleveland, Benjamin

doi:10.1007/s11701-019-00982-7

Cited by 10 publications

(5 citation statements)

References 19 publications

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“…LH has been simplified because of technical developments and surgeon experience, which has reduced both operating time and length of hospital stay. 18,29 In our experience, LH is advantageous regarding productivity loss with a five-year horizon, which is an important factor for reducing total costs. This may be an important reason why, in the same circumstances, both approaches should be considered equally, especially taking into account that short hospital stay, low complication rate, and minimally invasive approach are attractive features for patients considering hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Healthcare and Indirect Cost of the Laparoscopic vs. Vaginal Approach in Benign Hysterectomy

Martínez-Maestre

Jódar-Sánchez

Calderón-Cabrera

et al. 2022

JSLS

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Background and Objectives: The aim of this study was to analyze indirect costs of vaginal and laparoscopic routes for hysterectomy to determine whether this makes a difference in total costs when considering route for surgery.Methods: A five-year observational retrospective cohort study was conducted in an academic tertiary care center. A total of 517 patients scheduled for total laparoscopic hysterectomy (n = 137) and vaginal hysterectomy (n = 380) for benign conditions between January 1, 2008 and December 31, 2012 meeting inclusion criteria were reviewed.Results: Indirect costs were higher in the vaginal hysterectomy group compared to the laparoscopic hysterectomy group (mean cost e3,239.86 vs. e1,371.58; cost increase of e1,868.28; p < .001). Indirect costs due to lostwork-productivity were the most important, represented by 97.7% in the vaginal group and 93.6% in the laparoscopic group.Conclusion: Among women undergoing hysterectomy for benign disease, laparoscopic hysterectomy appears to be superior to vaginal hysterectomy when indirect costs are analyzed in a five-year temporal horizon. Laparoscopic hysterectomy is a good alternative to vaginal hysterectomy when technically feasible as both present comparable advantages. The surgical approach to hysterectomy should be decided in light of the relative benefits and hazards, which will depend on clinical circumstances and surgical expertise.

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Section: Discussionmentioning

confidence: 99%

Healthcare and Indirect Cost of the Laparoscopic vs. Vaginal Approach in Benign Hysterectomy

Martínez-Maestre

Jódar-Sánchez

Calderón-Cabrera

et al. 2022

JSLS

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“…Today, surgical costs and operative times are increasingly critical given the need to improve contribution margins in surgical procedures as a key driver in hospital profitability. Moreover, with the growing understanding of best practices in robotic surgery and related robotic program optimisation, 6,7 newer studies and publications are demonstrating that, in specific robotic surgery case types, including benign hysterectomy, cases can be performed for comparable or even lower cost when compared to laparoscopy, with equivalent clinical outcomes 6–10 …”

Section: Introductionmentioning

confidence: 99%

“…growing understanding of best practices in robotic surgery and related robotic program optimisation, 6,7 newer studies and publications are demonstrating that, in specific robotic surgery case types, including benign hysterectomy, cases can be performed for comparable or even lower cost when compared to laparoscopy, with equivalent clinical outcomes. [6][7][8][9][10] 1. 1…”

mentioning

confidence: 99%

Senhance surgical system in benign hysterectomy: A real‐world comparative assessment of case times and instrument costs versus da Vinci robotics and laparoscopic‐assisted vaginal hysterectomy procedures

Coussons¹,

Feldstein²,

McCarus

2021

Robotics Computer Surgery

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Objectives Comparison of retrospective, learning curve benign hysterectomy cost and case time data from Senhance total laparoscopic hysterectomy (TLH) cases with similar da Vinci robot cases and laparoscopic‐assisted vaginal hysterectomy (LAVH) cases. Methods Instrument costs, console time, and case time analysis from six surgeons at four U.S. and European hospitals compared with retrospective, sequential da Vinci TLH and standard laparoscopic LAVH cases extracted from the CAVAlytics database. Results Senhance Gyn surgeons in their learning curve when compared to da Vinci learning curve Gyn surgeons achieved lower median instrument costs ($559 vs. $1393, respectively, p < 0.001) with comparable console times (91.5 vs. 96 min, p = 0.898); Senhance and LAVH case costs were comparable ($559 vs. $498, p = 0.336). Conclusion In benign hysterectomy, the Senhance system may present a lower‐cost approach with equivalent case times compared with similar da Vinci robotic cases.

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“…In comparison with minimally invasive approaches, total abdominal hysterectomy (TAH) remains a major surgical procedure with the need for lengthier hospital admission and a higher complication rate 4,5 . In the past decades, total laparoscopic hysterectomy (TLH) and robot‐assisted hysterectomy (RAH) were developed to combat these shortcomings, allowing swifter recovery with shorter hospitalisations and reduced morbidity, and these techniques have since been utilised more often 1,6‐8 . However, mixed reports exist about the true costs between these different approaches for hysterectomy 6,7 .…”

Section: Introductionmentioning

confidence: 99%

“…In the past decades, total laparoscopic hysterectomy (TLH) and robot‐assisted hysterectomy (RAH) were developed to combat these shortcomings, allowing swifter recovery with shorter hospitalisations and reduced morbidity, and these techniques have since been utilised more often 1,6‐8 . However, mixed reports exist about the true costs between these different approaches for hysterectomy 6,7 . Especially in a European setting data concerning true costs are limited.…”

Section: Introductionmentioning

confidence: 99%

The clinical and financial impact of introducing robotic‐assisted hysterectomy in a tertiary referral centre: A direct cost analysis of consecutive hysterectomies during a decade

Dumont

Trappen

2021

Robotics Computer Surgery

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Background: Economic data and the clinical impact of introducing robotic-assisted hysterectomy in a European setting are scarce with conflicting findings. Methods:In this retrospective cohort study, the cost and complication rate of the different approaches of hysterectomy are investigated, both benign and (pre)malignant indications were included.Results: 844 patients were included: 323 (38.3%) patients underwent roboticassisted hysterectomy (RAH), 317 (37.5%) total abdominal hysterectomy (TAH), and 204 (24.2%) total laparoscopic hysterectomy (TLH). TAH dropped from 67.2% to 25.5% of procedures, whilst RAH rose to 41.8% of cases. The total hospitalisation cost was for RAH €5208.39 (�€916.91), for TAH €5846.61 (�€4464.37) and for TLH €3790.06 (�€1267.05). The postoperative complication rate of TAH (9.1%) was significantly higher in comparison with TLH and RAH (5.4% and 3.1%, respectively, p = 0.005).Conclusions: RAH has replaced TAH in most cases, especially for large uteri, earlystage endometrial cancer and in selected endometriosis cases, resulting in reduced morbidity with lower hospitalisation costs. The indications for TLH remained, including menorrhagia, adenomyosis and persistent cervical dysplasia.

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Direct cost of hysterectomy: comparison of robotic versus other routes

Cited by 10 publications

References 19 publications

Healthcare and Indirect Cost of the Laparoscopic vs. Vaginal Approach in Benign Hysterectomy

Healthcare and Indirect Cost of the Laparoscopic vs. Vaginal Approach in Benign Hysterectomy

Senhance surgical system in benign hysterectomy: A real‐world comparative assessment of case times and instrument costs versus da Vinci robotics and laparoscopic‐assisted vaginal hysterectomy procedures

The clinical and financial impact of introducing robotic‐assisted hysterectomy in a tertiary referral centre: A direct cost analysis of consecutive hysterectomies during a decade

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