Using Robots to Help Surgeons is Expensive

Prostate cancer surgery robotic assistance costly for hospitals

(RxWiki News) The use of robotic-assisted surgery is only a few years old, and some surgeons have taken a real shine to having a previously unknown level of precision and control during an operation.

However, while some studies show that outcomes are better, hospitals are beginning to look at the bottom line.

The sizeable expense of purchasing advanced robots to help surgeons needs to be justified, and a recent study shows that the cost to the hospital is sizeable when robots are used.

"Ask your surgeon about the different surgical options."

The average cost to the hospital using robotic-assistance for prostate cancer surgery was a loss of $4,013, whereas standard prostatectomy resulted in a profit of $1,324, according to the study.

While most costs for the surgery were similar, the study showed that in addition to the initial purchase and operating costs of the machinery, nursing costs were also higher following robotic surgery by $1,500.

The study was not the first analysis of the cost involved with robotic assistance, but previous studies did not account for all factors. 

By including all costs for both surgeries and carefully selecting hospitals used in the study, researchers made this study the most comprehensive yet, and nipped in the bud many of the arguments made against earlier studies.

Although by no means the final word on the matter, authors pointed out that even after 37 different comparisons have analyzed the benefits of robotic surgery, no clear advantages have been proven for surgeries using robots.

Ultimately, doctors will have to wait for randomized clinical trials to be published before making decisions, but until conclusive proof showing the benefits of robotic assisted surgery is found, many struggling hospitals may postpone the purchase of the robotic equipment indefinitely.

Even after the initial purchase of equipment, the study shows that nursing costs are shown to be continually higher.

According to Joel Nelson, MD, one of the study authors from the University of Pittsburgh, "It is reasonable to question whether the increased costs of this robotic-assisted approach are justified. While further studies are needed to compare the long-term outcomes of RRP vs. RARP, our study suggests that our society may be paying too high a price for what has been widely perceived as a medical advance."

Dr. Nelson acknowledges that surgical practices of many urologists in the United states may be determined by evidence in studies like this more than the preferences of surgeons.

"The value of care for patients is of particular concern to a nation struggling to control health care costs while improving outcomes."

Cost analysis of the two prostate cancer surgical methods followed 473 patients between July 2009 and October 2011, with four urologists performing all of the surgeries in the study, switching between robotic-assisted laparoscopic radical prostatectomy (RARP) and the standard open radical retropubic prostatectomy (RRP).

Results from the comparative study on surgical treatment of localized prostate cancer was published online in The Journal of Urology on April 3, 2012.

Researchers did not disclose any possible conflicts of interest due to funding.

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Review Date: 
June 2, 2012