Is robot-assisted hysterectomy worth the extra cost? | On Call

February 20, 2013 by MassDevice staff

Researchers question the value of robot-assisted hysterectomy, finding few short-term benefits to justify the higher cost of the procedure.

MassDevice On Call

MASSDEVICE ON CALL — Robot-assisted procedures are making up an ever greater portion of hysterectomies, but researchers aren't sure that the extra cost leads to better outcomes.

"Proponents of robotic surgery have argued that robotic technology allows women who otherwise would undergo laparotomy to have a minimally invasive procedure," according to the report. "However, there is little to support these claims, and because both laparoscopic and robotic-assisted hysterectomy are associated with low complication rates, it is unclear what benefits robotically assisted hysterectomy offers."

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Hysterectomy is among the most commonly performed procedures in women, likely to affect 1 in 9 women in their lifetimes, the researchers noted.

Robot-assisted hysterectomies made up 0.5% of such procedures in 2007, but that rate had grown to 9.5% by 2010. Laparoscopic procedures also increased during that time, going from 24.3% in 2007 to 30.5% in 2010, according to the report.

"Would it be a better use of resources to train more surgeons in laparoscopic techniques than to spend the money on more robot machines?" the researchers asked. "When the innovation being advertised is of questionable advantage, direct-to-consumer promotion may only fuel unnecessary utilization."

"In the absence of additional research or decreases in price, the path taken by the medical and payer community should be one of caution," they concluded. "At a minimum, manufacturers might begin by voluntarily restricting their promotional activities."