Robotic Ovarian Surgery Linked to Higher Costs, Complications

October 15, 2014 — The use of robotic surgery has been linked to substantially higher costs and a small increased risk of complications compared to traditional laparoscopic surgery, according to a study published in Obstetrics & Gynecology.

Conclusions of the study were based on data from 87,514 women who had adnexal surgery from 2009-2012. This surgery removes the ovaries, fallopian tube, and/or ovarian cysts, usually as a treatment for ectopic pregnancy, ovarian cancer, inflammation, or severe cysts.

During the study, the use of robot-assisted surgery to remove the ovaries (oophorectomy) increased from 3.5% to 15%. The overall complication rate for this procedure was 7.1% for robot-assisted surgery vs. 6% for laparoscopic surgery. The intraoperative complication rate was also higher for robot-assisted surgery — 3.4% compared with 2.1% of non-robotic procedures.

Robot-assisted surgery to remove ovarian cysts (cystectomy) increased from 2.4% to 12.9% during the study. Overall, the complication rate was 38% higher for robot-assisted procedures (3.7% vs. 2.7%). The intraoperative complication rate was also higher, 2% vs 0.9% for non-robotic procedures.

Researchers also found significantly higher costs associated with robotic surgery:

“Compared with laparoscopy, robotically assisted oophorectomy was associated with $2,504 increased total costs and robotically assisted cystectomy $3,310 higher costs.”

The findings of this study back up several other studies confirming higher costs and risks, with no evidence of a clinical benefit for the patient. Last year, Obstetrics & Gynecology published another study showing that robotic hysterectomies (surgery to remove the uterus) were nearly $2,500 more expensive but no better than laparoscopic surgery. Similar findings have been published on prostate-removal surgery and bladder cancer surgery.