Similar morbidity for robotic, laparoscopic hysterectomy

But robotic treatment significantly more costly for treatment of endometrial cancer

While complication rates are similar between robotic and laparoscopic hysterectomies for the treatment of endometrial cancer, robotic treatment is significantly more costly than laparoscopic treatment, according to a study published online Jan. 30 in the Journal of Clinical Oncology.

Jason D. Wright, M.D., from the Columbia University College of Physicians and Surgeons in New York City, and colleagues used the Perspective database to identify 2,464 women who underwent a minimally invasive hysterectomy for endometrial cancer from 2008 to 2010; of which, 1,027 (41.7%) underwent laparoscopic hysterectomy and 1,437 (58.3%) underwent robotic hysterectomy. Using multivariable logistic and linear regression models, morbidity, mortality, and cost were assessed.

The researchers found that the overall complication rate was 9.8 and 8.1% for laparoscopic hysterectomy and robotic hysterectomy, respectively (P = 0.13). For any morbidity resulting from a robotic hysterectomy the adjusted odds ratio (OR) was 0.76 (95% confidence interval [CI], 0.56 to 1.03). There were no significant differences in the rates of intraoperative complications (OR, 0.68; 95% CI, 0.42 to 1.08), surgical site complications (OR, 1.49; 95% CI, 0.81 to 2.73), medical complications (OR, 0.64; 95% CI, 0.40 to 1.01), or prolonged hospitalization (OR, 0.85; 95% CI, 0.64 to 1.14) between the procedures, after adjusting for patient, surgeon, and hospital characteristics. The mean cost for robotic hysterectomy was significantly higher than laparoscopic hysterectomy ($10,618 versus $8,996).

“Despite claims of decreased complications with robotic hysterectomy, we found similar morbidity but increased cost compared with laparoscopic hysterectomy,” the authors write.

One author disclosed receiving honoraria from Intuitive Surgical.

The abstract is available at: http://jco.ascopubs.org/content/early/2012/01/30/JCO.2011.36.7508.abstract

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