Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Mar;12(1):137-44.
doi: 10.1002/rcs.1651. Epub 2015 Mar 30.

Introducing robotic surgery into an endometrial cancer service--a prospective evaluation of clinical and economic outcomes in a UK institution

Thomas E J Ind  1   2 , Chris Marshall  3 , Matthew Hacking  4 , Michelle Harris  1 , Liz Bishop  5 , Desmond Barton  1   2 , Jane E Bridges  1 , John H Shepherd  1 , Marielle Nobbenhuis  1
Affiliations

Introducing robotic surgery into an endometrial cancer service--a prospective evaluation of clinical and economic outcomes in a UK institution

Thomas E J Ind et al. Int J Med Robot. 2016 Mar.

Abstract

Background: We have assessed how the introduction of robotics in a publicly funded endometrial cancer service affects clinical and economic outcomes.

Methods: The study included 196 women. Costs were divided into those for wards, high dependency, staffing, theatres, pharmacy, blood products, imaging, pathology and rehabilitation. Capital depreciation was included.

Results: Prior to the introduction of robotics, 78/130 (60.0%) cases were performed open, compared to 17/66 (25.8%) afterwards (p < 0.0001). The median operative time increased 37 min (95% CI 17-55 min; p = 0.0002); the median blood loss was 55 ml lower (95% CI 0-150 ml; p = 0.0181); the stay was 2 days shorter (95% CI 1-3; p < 0.0001). Complications reduced from 64/130 (49.2%) to 19/66 (28.8%) (p = 0.0045). Costs reduced from £11 476 to £10 274 (p = 0.0065). Conversions for 'straight stick' surgery were 18.2% (14/77) compared to 0.0% (0/24) for robotics (p = 0.0164).

Conclusions: Introducing robotics resulted in fewer laparotomies, shorter stays, fewer complications and lower costs.

Keywords: complications; economic evaluation; endometrial cancer; laparoscopy; robotic surgery.

PubMed Disclaimer

Conflict of interest statement

In 2007, Thomas Ind and John Shepherd received 2 days of practical training in robotic surgery. This included premium economy class travel to the USA and accommodation costs paid for, and organized by, Intuitive Surgical Inc. (CA, USA). Intuitive Surgical also sponsored a day's preceptorship for Marielle Nobbenhuis and Thomas Ind at the Royal Marsden Hospital in 2013. In May 2014, both Marielle Nobbenhuis and Thomas Ind received a day of training in Germany (including travel and accommodation) sponsored by Intuitive Surgical; neither robotic surgeon has worked for Intuitive Surgical as a proctor. Thomas Ind is an officer of both the British and Irish Association of Robotic Gynaecological Surgeons (BIARGS) and the British Society of Gynaecological Endoscopy (BSGE).

Figures

Figure 1
Figure 1
The proportion of women receiving open, straight stick and laparoscopic surgery before and after the introduction of robotics
See this image and copyright information in PMC

References

    1. Tapper AM, Hannola M, Zeitlin R, et al. A systematic review and cost analysis of robot‐assisted hysterectomy in malignant and benign conditions. Eur J Obstet Gynecol Reprod Biol 2014; 177: 1–10. - PubMed
    1. Lau SV, Vankin Z, Ramana‐Kumar AV, et al. Outcomes and cost comparisons after introducing a robotics program for endometrial cancer surgery. Obstet Gynecol 2012; 119: 717–724. - PubMed
    1. Dindo C, Clavien PA. What is a surgical complication? World J Surg 2008; 32: 939–941. - PubMed
    1. Leitao MM, Jr , Bartashnik A, Wagner I, et al. Cost‐effectiveness analysis of robotically assisted laparoscopy for newly diagnosed uterine cancers. Obstet Gynecol 2014; 123: 1031–1037. - PMC - PubMed
    1. Barnett JC, Judd JP, Wu JM, et al. Cost comparison among robotic, laparoscopic, and open hysterectomy for endometrial cancer. Obstet Gynecol 2010; 116: 685–693. - PubMed

LinkOut - more resources