Costs, complications increased with robotics for adnexal surgery

October 16, 2014

An analysis of data from nearly 90,000 women who underwent adnexal surgery over a 3-year period shows that robotically assisted procedures were associated with substantially higher costs and increases in intraoperative complications.

 

An analysis of data from nearly 90,000 women who underwent adnexal surgery over a 3-year period shows that robotically assisted procedures were associated with substantially higher costs and increases in intraoperative complications. The findings, published in Obstetrics & Gynecology, were from a population-based comparison of laparoscopic and robotically assisted procedures.

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Using a nationwide database, the researchers identified 87,514 women who had undergone adnexal surgery from 2009 to 2012. During that period, they found, use of robotic-assisted oophorectomy increased from 3.5% to 15% and robotically assisted cystectomy from 2.4% to 12.9%.

For robotically assisted versus laparoscopic oophorectomy, the overall complication rates were 7.1% and 6.0%, respectively (odds ratio [OR] 1.20, 95% CI 1.00-1.45, P=.052). The rate of intraoperative complications was higher when oophorectomy was robotically assisted (3.4% versus 2.1%, OR 1.60, 95% CI 1.21-2.13).

Looking at robotically assisted versus laparoscopic cystectomy, the authors found overall complication rates of 3.7% and 2.7%, respectively. The intraoperative complication rate was higher for the robotically assisted procedures (2.0% versus 0.9%, OR 2.40, 95% CI 1.31-4.38).

Comparing costs of robotic versus laparoscopic procedures, total costs for oophorectomy were $2,504 higher (95% CI $2,356-$2.652) and for cystectomy were $3,310 higher (95% CI $3,082-$3,581) with the robot.

During a period when use of robotically assisted adnexal surgery increased rapidly, the authors concluded, the technology was associated with substantially higher costs and a small but statistically significant increase in intraoperative complications compared with laparoscopy. 


 

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