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Obstetrics and Gynecology International
Volume 2011 (2011), Article ID 973830, 6 pages
http://dx.doi.org/10.1155/2011/973830
Review Article

Are Costs of Robot-Assisted Surgery Warranted for Gynecological Procedures?

1Department of Gynecology, Sint Augustinus Hospital, B2610 Wilrijk, Belgium
2Department of Medical Oncology, Sint Augustinus Hospital, B2610 Wilrijk, Belgium

Received 14 May 2011; Accepted 6 July 2011

Academic Editor: Linus Chuang

Copyright © 2011 Peter van Dam et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The exponential use of robotic surgery is not the result of evidence-based benefits but mainly driven by the manufacturers, patients and enthusiastic surgeons. The present review of the literature shows that robot-assisted surgery is consistently more expensive than video-laparoscopy and in many cases open surgery. The average additional variable cost for gynecological procedures was about 1600 USD, rising to more than 3000 USD when the amortized cost of the robot itself was included. Generally most robotic and laparoscopic procedures have less short-term morbidity, blood loss, intensive care unit, and hospital stay than open surgery. Up to now no major consistent differences have been found between robot-assisted and classic video-assisted procedures for these factors. No comparative data are available on long-term morbidity and oncologic outcome after open, robotic, and laparoscopic gynecologic surgery. It seems that currently only for very complex surgical procedures, such as cardiac surgery, the costs of robotics can be competitive to open surgical procedures. In order to stay viable, robotic programs will need to pay for themselves on a per case basis and the costs of robotic surgery will have to be reduced.