Robot-assisted hysterectomy may lead to fewer post-procedure hospital readmissions and far lower costs of related care when compared with laparoscopic, open or vaginal procedures, according to a retrospective analysis touted by Intuitive Surgical (NSDQ:ISRG).
The study, conducted by a team of researchers led by Dr. Martin Martino of Lehigh Valley Health Network, found lower rates of 30-day readmission, less average blood loss, shorter readmission hospital stays and lower costs overall associated with post-hysterectomy readmissions in patients who received robot-assisted hysterectomies.
The study examined more than 2,500 instances of hysterectomy in patients with benign disease, spanning procedures conducted from January 2008 to December 2012, according to an Intuitive Surgical statement. In total the study included 601 instances of robot-assisted hysterectomy, 427 laparoscopic, 1,194 open and 332 vaginal. Researchers examined patients’ clinical records, although some patients outcomes were lost to outside hospitals.
In general the researchers found that robot-assisted surgery resulted in readmission rates that were half or less than rates associated with the other procedures and that total costs associated with readmission were, on average, from 35% to 90% less than for other types of hysterectomy.
The analysis is the latest to evaluate robot-assisted surgery against other types of procedures, although most other recent reports have focused on comparing robot-assisted prostatectomy and most have compared against open surgery. The advantages of robot-assisted surgery over other minimally invasive techniques has been the source of some debate.
Some studies have criticized da Vinci procedures as a costlier type of minimally invasive surgery that confers few benefits over laparoscopic procedures. A study published last year reported that robotic surgery complications may be under-reported and therefore less safe than they appear, a conclusion Intuitive called "misleading." Other studies have raised similar concerns regarding robotic surgery prostatectomies and robotic surgeries to treat endometrial cancer.
Dr. Martino of Pennsylvania’s Lehigh Valley Health Network is a vocal advocate of robot-assisted surgery, although Intuitive Surgical reports that he was not given funding for this most recent analysis. He has "received travel reimbursement from Intuitive Surgical for educational research unrelated to this study," but otherwise was free of conflicts of interest associated with this retrospective analysis, according to Intuitive Surgical’s press release.
Martino’s study was also published online in the Journal of Minimally Invasive Gynecology.
Intuitive has been under a microscope in recent months as patient injury lawsuits have helped to spur a flurry of adverse event reports tied to the da Vinci system. Growing complaints have drawn the ire of some activist investors and prompted a lot of media attention, despite Intuitive’s claims that adverse events have been in decline compared with growing utilization of the technology.
President & CEO Gary Guthart last month defended the company’s da Vinci robot-assisted surgical system, saying that the "vigorous" public debate over the risks and adverse events has played a big part in the company’s deceleration over the past few quarters.