Introducing robotic radical hysterectomy for stage 1bi cervical cancer-A prospective evaluation of clinical and economic outcomes in a single UK institution

Int J Med Robot. 2019 Feb;15(1):e1970. doi: 10.1002/rcs.1970. Epub 2018 Dec 3.

Abstract

Background: We have assessed the impact of introducing robotics for a stage 1b cervical cancer service on laparotomy rates, complications, and costs.

Methods: Data were collected prospectively from 90 consecutive patients who had a radical hysterectomy between 1 April 2010 and 31 December 2017.

Results: There were 37 women before the first robotic procedure and 53 after. The laparotomy rate reduced from 75% (9/12) in 2010 to 0% (0/18) in 2017. The length of stay reduced from 6 days (range 3-39) to 3 days (range 1-15) (P < 0.0001). The complication rate before robotics was 68% (25/37) compared with 45% (24/53) afterwards (P = 0.0493). The blood transfusion rate reduced from 43% (16/37) to 11% (6/53) (P = 0.0007). There were no differences between the total costs before and after the introduction of robotics or between each route.

Conclusions: In this series, introducing robotics for cervical carcinoma reduced hospital stay and complications. No cost differences were demonstrated.

Keywords: cervical cancer; complications; costs; radical hysterectomy.

MeSH terms

  • Adult
  • Aged
  • Female
  • Health Care Costs
  • Humans
  • Hysterectomy / economics*
  • Hysterectomy / methods*
  • Middle Aged
  • Models, Economic
  • Prospective Studies
  • Robotic Surgical Procedures*
  • Treatment Outcome
  • United Kingdom
  • Uterine Cervical Neoplasms / economics*
  • Uterine Cervical Neoplasms / surgery*