Is Robotic Hysterectomy Better Than Laparoscopy?

Robotic hysterectomy has become increasingly popular over the last few years, but a new study in the Journal of the American Medical Association calls its value into question. The study says robotic surgery costs one-third more than minimally invasive surgery without imparting better outcomes for the price.

Researchers examined the records of 264,758 women who underwent hysterectomies for benign gynecologic disorders at 441 U.S. hospitals between 2007 and 2010. They compared hospital stay lengths and complications associated with robotically assisted, abdominal and laparoscopic hysterectomies to determine the benefits of the robotic procedure.

During the time period studied, an increase was seen in both robotic assistance (up 0.5%, to represent 9.5% of all hysterectomies) and laparoscopic approaches (rising from 24.3% to 30.5% of the total). Facilities that had robotic systems performed almost 25% of hysterectomies robotically.

Overall complication rates were similar for robotic-assisted (5.5%) and laparoscopic (5.3%) hysterectomies. About 25% of laparoscopy patients had hospital stays longer than 2 days, compared with fewer than 20% for robot-assisted. The similarities ended when it came to price. The average total cost to the hospital for the robotic hysterectomy was $8,868, compared with $6,679 for a laparoscopic procedure and $6,651 for open surgery.

According to an article in the Wall Street Journal, 1,370 U.S. hospitals have purchased at least 1 robotic surgery system since 2000, at $1.5 million to $2.2 million each.

Stephanie Wasek