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Observational Study
. 2022 Mar;125(4):747-753.
doi: 10.1002/jso.26769. Epub 2021 Dec 14.

A prospective comparison of costs between robotics, laparoscopy, and laparotomy in endometrial cancer among women with Class III obesity or higher

Sarah D Kosa  1   2 , Sarah E Ferguson  1   3 , Tony Panzarella  4 , Susie Lau  5 , Jeremie Abitbol  5 , Vanessa Samouëlian  6 , Christopher Giede  7 , Helen Steed  8 , Benjamin Renkosinski  1 , Lilian T Gien  3   9 , Marcus Q Bernardini  1   3
Affiliations
Observational Study

A prospective comparison of costs between robotics, laparoscopy, and laparotomy in endometrial cancer among women with Class III obesity or higher

Sarah D Kosa et al. J Surg Oncol. 2022 Mar.

Abstract

Background and objectives: To compare the immediate operating room (OR), inpatient, and overall costs between three surgical modalities among women with endometrial cancer (EC) and Class III obesity or higher.

Methods: A multicentre prospective observational study examined outcomes of women, with early stage EC, treated surgically. Resource use was collected for OR costs including OR time, equipment, and inpatient costs. Median OR, inpatient, and overall costs across surgical modalities were analyzed using an Independent-Samples Kruskal-Wallis Test among patients with BMI ≥ 40.

Results: Out of 520 women, 103 had a BMI ≥ 40. Among women with BMI ≥ 40: median OR costs were $4197.02 for laparotomy, $5524.63 for non-robotic assisted laparoscopy, and $7225.16 for robotic-assisted laparoscopy (p < 0.001) and median inpatient costs were $5584.28 for laparotomy, $3042.07 for non-robotic assisted laparoscopy, and $1794.51 for robotic-assisted laparoscopy (p < 0.001). There were no statistically significant differences in the median overall costs: $10 291.50 for laparotomy, $8412.63 for non-robotic assisted laparoscopy, and $9002.48 for robotic-assisted laparoscopy (p = 0.185).

Conclusion: There was no difference in overall costs between the three surgical modalities in patient with BMI ≥ 40. Given the similar costs, any form of minimally invasive surgery should be promoted in this population.

Keywords: Class III obesity; cost analysis; endometrial cancer; laparotomy; minimally invasive surgery; robotic surgery.

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References

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