Da Vinci hysterectomy under investigation
Since 2011, hysterectomy became the most common procedure of the da Vinci. There are approximately 600,000 cases a year in the US, and da Vinci hysterectomy (approved in 2005) has increased its penetration from 0.5% in 2007 to 9.5% in 2010. A recent study published in the Journal of the American Medical Association found no difference in the surgical outcome of dVH versus hand-held laparoscopy. (Even the editorial was analyzing these results: "rapid dissemination of robotic surgery in the United States may be linked to a number of converging factors, including better ergonomics for the surgeon, marketing campaigns, and the national fascination with technology and innovation...")
"Cohort study of 264 758 women who underwent hysterectomy for benign gynecologic disorders at 441 hospitals across the US from 2007 to 2010 found:
- the overall complication rates were similar for robotic-assisted and laparoscopic hysterectomy (5.5% vs 5.3%; relative risk [RR])
- patients who underwent a robotic-assisted hysterectomy were less likely to have a length of stay longer than 2 days (19.6% vs 24.9%; RR)
- transfusion requirements (1.4% vs 1.8%; RR)
- rate of discharge to a nursing facility (0.2% vs 0.3%; RR)
Total costs associated with robotically assisted hysterectomy were $2189 more per case than for laparoscopic hysterectomy. Median cost to the hospital of robotic procedure is $8,868, compared with $6,679 for laparoscopic hysterectomy."
You can read a more thorough analysis of the article here.