Study of surplus cost of robotic assistance for radical hysterectomy, versus laparotomy and standard laparoscopy [étude du surco?t de la c?lioscopie assistée par robot dans l'hystérectomie élargie]

摘要

Objectives: The study purpose was to compare the costs among robotic, laparoscopic and open radical hysterectomy for cervical cancer. Patients and methods: Thirty-seven patients underwent robotic radical hysterectomy for cervical cancer. Cases were performed by three surgeons, at two institutions, and were retrospectively reviewed to perform a cost comparison between all three modalities. We included costs for edible materials in anesthesia and surgery, but costs for staff and indirect financial expenses were excluded. Those data are compared to open and laparoscopic radical hysterectomy data. Results: The average cost for robotic assistance presented a surplus of 1796 euros compare to laparotomy and 1313 euros compare to standard laparoscopy in 2008, and 1320 and 837 euros respectively. Discussion and conclusion: The average cost for radical hysterectomy was highest for robotic, followed by standard laparoscopy, and least for laparotomy. However, over only 2 years of use, this difference tends to decrease. Medico-economic impact is the main restraint for robotic assistance development, and needs to be assessed permanently.