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Cost analysis of minimally invasive hysterectomy vs open approach performed by a single surgeon in an Italian center

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Abstract

Despite the rapid uptake of robotic surgery, the effectiveness of robotically assisted hysterectomy (RAH) remains uncertain, due to the costs widely variable. Observed the different related costs of robotic procedures, in different countries, we performed a detailed economic analysis of the cost of RAH compared with total laparoscopic (TLH) and open hysterectomy (OH). The three surgical routes were matched according to age, BMI, and comorbidities. Hysterectomy costs were collected prospectively from September 2014 to September 2015. Direct costs were determined by examining the overall medical pathway for each type of intervention. Surgical procedure cost for RAH was €3598 compared with €912 for TLH and €1094 for OH. The cost of the robot-specific supplies was €2705 per intervention. When considering overall medical surgical care, the patient treatment average cost of a RAH was €4695 with a hospital stay (HS) of 2 days (range 2–4) compared with €2053 for TLH and €2846 for OH. The main driver of additional costs is disposable instruments of the robot, which is not compensated by the hospital room costs and by an experienced team staff. Implementation of strategies to reduce the cost of robotic instrumentation is due. No significant cost difference among the three procedures was observed; however, despite the optimal operative time, the experienced, surgeon and the lower HS, RAH resulted 2, 3 times and 1, 6 times more expensive in our institution than TLH and OH, respectively.

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Acknowledgments

We would like to thank Maria Gaetani, MD, the University of Bari, Bari, Italy, for valuable input on the content and semantics of the manuscript. We would like to thank financial department staff of ASTT LECCO (Alessandro Manzoni Hospital, Lecco, Italy) for their contribution.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, ASTT LECCO, Alessandro Manzoni Hospital, Dell’Eremo Street 11, Lecco, Italy

    Antonio Pellegrino, Gianluca Raffaello Damiani, Giorgio Fachechi, Silvia Corso, Cecilia Pirovano, Claudia Trio, Mario Villa & Daniela Turoli

  2. Department of Obstetrics and Gynecology, University of Bologna-Sant’orsola, Bologna, Italy

    Gianluca Raffaello Damiani & Aly Youssef

Authors
  1. Antonio Pellegrino
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  2. Gianluca Raffaello Damiani
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  3. Giorgio Fachechi
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  4. Silvia Corso
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  5. Cecilia Pirovano
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  6. Claudia Trio
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  7. Mario Villa
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  8. Daniela Turoli
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  9. Aly Youssef
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Correspondence to Gianluca Raffaello Damiani.

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All authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Pellegrino, A., Damiani, G.R., Fachechi, G. et al. Cost analysis of minimally invasive hysterectomy vs open approach performed by a single surgeon in an Italian center. J Robotic Surg 11, 115–121 (2017). https://doi.org/10.1007/s11701-016-0625-5

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  • DOI: https://doi.org/10.1007/s11701-016-0625-5

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