Another study finds robotic surgery equal but pricier

Study: Robotic hysterectomy no better than laparoscopy, costs more

Hysterectomies using surgical robots like Intuitive Surgical‘s (NSDQ:ISRG)’s da Vinci device are no better than hysterectomies performed laparoscopically, but cost a lot more per procedure, according to a study in the journal Obstetrics & Gynecology.

The researchers examined data from 804,551 hysterectomies performed in 2009 and 2010, of which 20.6% were performed laparoscopically and 5.1% with robotic surgery (the balance were traditional, open surgeries). For the minimally invasive procedures, robotic surgery increased from 9.5% to 13.6%, they found.

Complication rates for laparoscopy and robotic surgery were similar (8.9% for laparoscopy, vs. 8.8% for robotic surgery), but the average cost for robotic surgery was $2,489 higher, according to the study. Per-procedure costs for robotic surgery ranged between $7,105 and $12,780, while laparoscopies cost $5,650-$9,583, the study found.

"The use of robotic hysterectomy has increased. Perioperative outcomes are similar between laparoscopic and robotic hysterectomy, but robotic cases cost substantially more," the researchers wrote. "Unfortunately, the greater costs associated with robotic-assisted hysterectomy were not reflected in improvement in outcomes."

Intuitive argued against the import of the comparison with laparoscopy, arguing that most of the robotic surgery patients would otherwise have undergone open surgery because they tended to be older and heavier and suffered a higher rate of chronic conditions like diabetes.

"Given these facts, it is likely that a substantial percentage of patients who received a robotic-assisted hysterectomy would have otherwise received an open hysterectomy,"Intuitive spokeswoman Angela Wonson told Bloomberg BusinessWeek via email.

The data for the Obstetrics & Gynecology study was compiled of "matched cohorts of patients undergoing robotic and laparoscopic hysterectomy," meaning the groups were of similar age and health. The robotic surgery group required fewer transfusions, according to the study, but were more likely to develop post-operative pneumonia.

It’s the latest in a series of studies to find robotic surgery more expensive and equally safe and effective as laparoscopy. Investors, who sent ISRG shares to an all-time high of $585.82 apiece in April 2012, have carved some 53% from the stock since then. ISRG shares were going for $383.53 each as of about 10:15 a.m. today, down 0.4%.

Prices tumbled 11.1% in a single day last February, to $509.33 per share, after a report in the Journal of the American Medical Assn. also questioned the value of hysterectomies using robotic surgery. In March, the president of the American College of Obstetricians & Gynecologists, Dr. James Breeden, criticized robotic surgery hysterectomies.

A study published earlier this month found that robotic surgeries may be under-reported and therefore less safe than they appear, a conclusion Intuitive called “misleading." Studies published last year raised similar concerns regarding robotic surgery prostatectomies and robotic surgeries to treat endometrial cancer.

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