Endometrial Cancer Surgery Costs: Robot vs Laparoscopy

Perioperative Outcomes in Robotic-Assisted Versus Conventional Laparoscopic Treatment of Endometrial Cancer

“…Most studies have compared RALS to laparotomy [7][8][9][10][11][12][13]. In addition, most studies comparing the various surgical techniques include several surgeons, whose potential differences in skill level may introduce a confounding variable into results.…”

The technique of robotic assisted laparoscopic surgery in gynaecology, its introduction

“…Even nerve-sparing surgical procedures in extended radical hysterectomies for what particularly the robotic assisted surgery has the potential have a promising perspective. A number of pending questions has to be answered, e. g. the insurance of the advantages of the robotic system by means of prospective controlled and randomized trials both regarding short-term parameters such as postoperative morbidity and amelioration of oncological outcome in long-term follow-up (12) and improved quality of life by reduced prolonged or chronic surgery associated morbidity, and arising costs (1,5,27,31,57). The feasibility of a multitude of gynaecological surgical interventions has been already approved partially in a small number of cases.…”

“…Surgical advantages are the more complex applicability of minimal invasive procedures, the distinct improved precision, dexterity and surgical sight guaranteed by stereoscopic view, resulting in a diminished prostration, a better adaptation to obese patients, a smaller learning curve due to a natural surgical feeling, a greater autonomy towards difficult controllable factors (e. g. camera guidance), an increase of preparation true to the anatomical structures, and finally the expected and from the mentioned factors resulting enlargement of the possible applications, which is only limited predictable at present. In contrast, disadvantages concern at least initially a greater time investment, a potentially different management of complications, even in relation to major hemorrhage in the surgical field, the limited applicability in the multiquadrant surgery, the indispensable reliability of the program support on the part of the hospital administration and management, and the not expected amelioration regarding cost coverage respectively recovery (1,5,27,31,57).…”

“…In Germany the use of the robotic system in gynaecological care is only at the beginning of a promising development. The spectrum of indications includes simple hysterectomies, above all in patients with uterine fibroids, with history of several previous abdominal operations, salpingoophorectomy in larger adnexal masses, interventions in extensive endometriosis, sacrocolpopexies, myomectomies (1,47,61), tubal reanastomosis and mainly the modified radical and radical hysterectomies (10, 20-22, 33, 41, 48, 49, 51, 53) in early stages of endometrial (16,25,26,28,31,32,36,37,50,(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69) and cervical cancer (12,42,65), especially nerve sparing radical hysterectomy, including pelvic and paraaortic, respectively upper paraaortic lymph node dissection, but also with less frequency trachelectomy, parametranectomy (3,11,14,52,54,55), interventions in early ovarian cancer (30,40), pelvic exenteration (15,35), colposuspension and the lateral colpopexy via transperitoneal approach (19,63,64), interventions in uterine malformations, and others (23). Many of these indic...…”

Étude du surcoût de la cœlioscopie assistée par robot dans l’hystérectomie élargie

“…Plusieurs publications rapportent des é tudes mé dico-é conomiques concernant la chirurgie assisté e par robot, en particulier avec le systè me Da Vinci, que ce soit en chirurgie gyné cologique [22][23][24][25][26][27][28][29][30] ou dans d'autres domaines tels que l'urologie, la chirurgie digestive ou encore la chirurgie cardiaque [24,[31][32][33][34][35][36][37][38].…”