• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Obstetrics

Robotic-assisted hysterectomy lacks cost-benefit

bys25qthea
February 20, 2013
in Obstetrics, Surgery
Reading Time: 4 mins read
0
Share on FacebookShare on Twitter

Feb 20th – The perioperative outcomes from robotically-assisted hysterectomy for benign gynecologic disease are similar to those for laparoscopic hysterectomy; however, the costs are much higher.

[tabs tab1=”2MM Rundown” tab2= “2MM Full Report”]

[tab]

Image: PD

1. The use of robotically-assisted hysterectomy for benign gynecologic disease has been increasing despite limited evidence demonstrating clinical benefit.

2. The perioperative outcomes from robotically-assisted hysterectomy for benign gynecologic disease are similar to those for laparoscopic hysterectomy; however, the costs are much higher.

This study’s population-based analysis demonstrates increasing rate of robotically-assisted hysterectomy for benign disease despite evidence of a similar perioperative morbidity profile as compared to laparoscopic hysterectomy. Of note, the cost for these robotic-assisted procedures is considerably higher, approximated to be up to $2000 more per case, about one third higher than the median cost for laparoscopic hysterectomy. This large study is more generalizable than previous single-institution studies and calls into question the drivers for the increase in number of robotic cases for which there appears to yield no clinical benefit. In clinical practice the clinician should be attuned to industry marketing efforts, surgeon preferences and novel technologies that influence choice, for these do not necessarily herald realized patient benefit. Robotic modalities can help a less-technically able surgeon learn the procedure in less time than the laparoscopic learning curve, but this doesn’t yet necessarily justify the increased fixed and variable costs of employing this technology for hysterectomy. Further comparative effectiveness studies are needed to examine resource allocation questions surrounding more traditional technique surgical training vs. acquiring more robotic machines.

RELATED REPORTS

Characterization of prognostic markers of residual neoplastic disease following hysterectomy

Laparoscopic hysterectomy equivalent to abdominal hysterectomy in disease-free and overall survival

Prophylactic tranexamic acid for decreased hysterectomy blood loss

Among limitations, this study did not examine benefits of robotic surgery for patients with certain anatomical challenges, as there may be a role for robotic-assisted hysterectomy in certain patient groups. Surgeon experience was also not a variable in this study. This could be important as robotic surgery outcomes are known to be considerably better at high volume centers by surgeons having more experience. Future studies will hopefully consider such variables in future analyses.

Click to read the study in JAMA

[/tab]

[tab]

Image: PD

1. The use of robotically-assisted hysterectomy for benign gynecologic disease has been increasing despite limited evidence demonstrating clinical benefit.

2. The perioperative outcomes from robotically-assisted hysterectomy for benign gynecologic disease are similar to those for laparoscopic hysterectomy; however, the costs are much higher.

This [retrospective cohort] study of 264,758 adult women among 441 US hospitals who had benign hysterectomies from 2007 to 2010 were classified based on surgical route: abdominal (123,288), vaginal (54,912), laparoscopic (75,761) or robotic-assisted (10,797). With risk adjustment for medical comorbidities, the following outcomes were analyzed: perioperative morbidity, mortality and resource allocation. The data were retrieved from the all-payer Perspective database (Premier).

Over the three years analyzed, robotically assisted hysterectomies increased by 9%, while  laparoscopic procedures increased by 6%. Use of vaginal and open procedures both declined by 2 and 13%, respectively. Patients who underwent robotic-assisted hysterectomy were less likely to have a stay longer than 2 days, but rates of perioperative complications were not significantly different between robotic and laparoscopic cohorts.

In sum: This study’s population-based analysis demonstrates increasing rate of robotically-assisted hysterectomy for benign disease despite evidence of a similar perioperative morbidity profile as compared to laparoscopic hysterectomy. Of note, the cost for these robotic-assisted procedures is considerably higher, approximated to be up to $2000 more per case, about one third higher than the median cost for laparoscopic hysterectomy. This large study is more generalizable than previous single-institution studies and calls into question the drivers for the increase in number of robotic cases for which there appears to yield no clinical benefit. In clinical practice the clinician should be attuned to industry marketing efforts, surgeon preferences and novel technologies that influence choice, for these do not necessarily herald realized patient benefit. Robotic modalities can help a less-technically able surgeon learn the procedure in less time than the laparoscopic learning curve, but this doesn’t yet necessarily justify the increased fixed and variable costs of employing this technology for hysterectomy. Further comparative effectiveness studies are needed to examine resource allocation questions surrounding more traditional technique surgical training vs. acquiring more robotic machines.

Among limitations, this study did not examine benefits of robotic surgery for patients with certain anatomical challenges, as there may be a role for robotic-assisted hysterectomy in certain patient groups. Surgeon experience was also not a variable in this study. This could be important as robotic surgery outcomes are known to be considerably better at high volume centers by surgeons having more experience. Future studies will hopefully consider such variables in future analyses.

Click to read the study in JAMA

By Mike Hoaglin and Rif Rahman

 

More from this author: Corticosteroid injections for tennis elbow associated with poorer recovery versus placebo, Glucose but not fructose reduces cerebral blood flow in appetite and reward centers of brain, Sustained etanercept with methotrexate is effective for achieving low disease activity in moderate rheumatoid arthritis patients

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain.

[/tab]

[/tabs]

Tags: hysterectomy
Previous Post

Fluid replacement with hydroxyethyl starch linked with higher mortality

Next Post

Researchers improve lung cancer risk model by incorporating more risk factors

RelatedReports

Similar outcomes after supracervical vs. total hysterectomy
Oncology

Characterization of prognostic markers of residual neoplastic disease following hysterectomy

January 4, 2023
Recurrence of endometrial hyperplasia following medical therapy is common
Obstetrics

Laparoscopic hysterectomy equivalent to abdominal hysterectomy in disease-free and overall survival

March 31, 2017
Prophylactic tranexamic acid for decreased hysterectomy blood loss
Obstetrics

Prophylactic tranexamic acid for decreased hysterectomy blood loss

February 7, 2016
Similar outcomes after supracervical vs. total hysterectomy
Obstetrics

Similar outcomes after supracervical vs. total hysterectomy

January 4, 2015
Next Post

Researchers improve lung cancer risk model by incorporating more risk factors

Health care costs not reduced after bariatric surgery

Dabigatran noninferior to warfarin for VTE

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Rocatinlimab may be effective in the treatment of moderate-to-severe atopic dermatitis
  • Gender-affirming hormones improve psychosocial functioning in transgender youth
  • Left atrial reservoir strain improves ischemic stroke risk prediction in low-risk patients
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options