MASSDEVICE ON CALL — Complication rates for women with endometrial cancer were roughly the same after standard laparoscopy and robot-assisted surgery, although the robotic procedures each cost about $1,300 more, according to a study in the Journal of Clinical Oncology.
The meta-analysis looked at data covering nearly 2,500 hysterectomies performed to treat endometrial cancer. About 60% of the women had robotic surgeries; the remainder had laparoscopic procedures. Among the latter, the complication rate was 9.8%, compared with 8.1% for the robot-assisted cohort – a difference study co-author Dr. Jason Wright said disappeared when factors such as race, insurance status and hospital location were taken into account.
“The bottom line is that there is really no difference in the complication rate between robotic and laparoscopic surgery, but robotic is much more expensive,” Wright told Reuters Health.
Robotic operations tracked in the study cost about $10,600 on average, compared with $9,000 or so for laparoscopic surgery. Other factors pare the difference to about $1,300 per procedure, according to the news service.
Market leader Intuitive Surgical (NSDQ:ISRG) said the extra cost is borne by health insurers, not patients, according to Reuters Health.
“Over the past 6 years the number of women receiving a less invasive approach to treating endometrial cancer has risen from approximately 14% to 65%,” spokesman Chris Simmonds told the news service in an email. “This has been achieved at no extra cost to the patient as reimbursement codes for robotic and standard laparoscopy are the same, yet numerous peer reviewed articles have documented clear improvements in many quality of life measures associated with surgery.”
The lack of randomized, controlled trials examining the 2 approaches to hysterectomy mean more regulation is needed, according to Wright, a gynecologic surgeon at Columbia University in New York, and his co-authors.
“Given our findings, systems to monitor the trends in utilization of robotic surgery would help to further define patterns of use,” co-author Dr. Dawn Hershman added in an email to Reuters Health.
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