Robot-Assisted Ovarian Surgery Tied to Higher Costs, Risks

October 15, 2014 — Obstetrics & Gynecology has published a study adding evidence that many robotic-assisted surgeries are much more expensive and potentially more dangerous than traditional laparoscopic surgery, without providing any clinical benefit for the patient.

The researchers looked at data on 87,514 women who had surgery to remove their ovaries, fallopian tubes, and/or ovarian cysts between 2009-2012.

During this time, the popularity of robotic surgery grew dramatically — from 3.5% to 15% of all ovary-removal surgeries (oophorectomy) and from 2.4% to 12.9% of all ovarian cyst-removal surgeries (cystectomy).

Unfortunately, robotic procedures were associated with higher costs and higher rates of complications

• Ovarian Cyst Surgery: Overall complication rate for robot-assisted surgery was 3.7% vs. 2.7% for laparoscopic surgery. Intraoperative complication rate was 2% for robot-assisted surgery vs. 0.9% for laparoscopic surgery. Cost for robotic surgery was $3,310 more expensive.
• Ovary Removal Surgery: Overall complication rate for robot-assisted surgery was 7.1% vs 6% for laparoscopic surgery. Intraoperative complication rate was 3.4% for robot-assisted surgery vs. 2.1% of laparoscopic surgery. Cost for robotic surgery was $2,504 more expensive.

In the last year, several other studies have also found evidence of higher costs and risks, with no clear benefit. This is concerning, because the devices are marketed as a way to reduce pain, bleeding, and recovery time.

One year ago, Obstetrics & Gynecology published a study that found robot-assisted hysterectomies were $2,500 more expensive than laparoscopy but provided no clinical benefit for the patient. Other studies have found similar conclusions for prostate surgery and bladder cancer surgery.