Cost assessment of robotics in gynecologic surgery: A systematic review

AimThe application of robotics is an innovation in the field of gynecologic surgery. Our objective was to evaluate the currently available literature on the cost assessment of robotic surgery of various operations in the field of gynecologic surgery. Material and MethodsPubMed and Scopus databases were systematically searched in order to retrieve the included studies in our review. ResultsWe retrieved 23 studies on a variety of gynecologic operations. The mean cost for robotic, open and laparoscopic surgery ranged from 1731 to 48769, 894 to 20277 and 411 to 41836 Euros, respectively. Operative charges, in hysterectomy, for robotic, open and laparoscopic technique ranged from 936 to 33920, 684 to 25616 and 858 to 25578 Euros, respectively. In sacrocolpopexy, these costs ranged from 2067 to 7275, 2904 to 69792 and 1482 to 2000 Euros, respectively. Non-operative charges ranged from 467 to 39121 Euros. The mean total costs for myomectomy ranged from 27342 to 42497 and 13709 to 20277 Euros, respectively, for the robotic and open methods, while the mean total cost of the laparoscopic technique was 26181 Euros. Conversions to laparotomy were present in 79/36185 (0.2%) cases of laparoscopic surgery and in 21/3345 (0.62%) cases of robotic technique. Duration of robotic, open and laparoscopic surgery ranged from 50 to 445, 83.7 to 701 and 74 to 330min, respectively. ConclusionRobotic surgery has the potential to become cost-effective in centers with many patients while industry competition could reduce the cost of the robotic instrumentation, making robotic technology more affordable and cost-effective.