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

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. © 2015 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery Published by John Wiley & Sons Ltd.