LBI-HTA - Publications - Search - Robot-assisted surgery: A systematic review of effectiveness and safety for elected indications and accumulating costs

Fischer, S. and Kisser, A. (2015): Robot-assisted surgery: A systematic review of effectiveness and safety for elected indications and accumulating costs. HTA-Projektbericht 84.

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Abstract

The primary aim of this report was to assess the efficacy and safety of robot-assisted surgery, compared to laparoscopic and open surgery for partial nephrectomy, adrenalectomy, radical prostatectomy, radical cystectomy, hysterectomy and ovariectomy. Furthermore, the costs (for acquisition, maintenance, etc.) of robotic surgery from the perspective of hospitals were calculated and the future of robotic surgery was evaluated.

In addition to a literature search, the respective manufacturers were contacted. Furthermore, for evaluating the future of robotic surgery, a survey was sent to Austrian experts. None of the 26 identified studies have shown a significant patient-relevant benefit of robot-assisted surgery – at least not for nephrectomy, adrenalectomy, prostatectomy, cystectomy or hysterectomy. There are probably some benefits of robotic-assisted surgery for outcomes such as length of hospital stay or potency after prostatectomy.

On average the acquisition costs of a da Vinci® surgical system are around 1.5 million Euros, with those for maintenance amounting to approx. 150,000 Euros per year and nearly 1600 Euros operational cost per surgery. The amortisation of a da Vinci® surgical system is only possible when a high number of cases is guaranteed and a high amount from the generated lump sums is provided to amortise the costs.

Overall, the experts prognosticated that robotic surgery in Austria will further grow, at least in certain fields. Due to an increasing competition pressure, the costs for robotic surgery could decrease in the future.

Item Type:Project Report
Keywords:Robotic surgery, robot-assisted surgery, da Vinci®, urology, gynaecology
Subjects:WK Endocrine system > WK 700-790 Adrenal glands
WO Surgery > WO 505 Minimally invasive surgical procedures
WX Hospitals and other health facilities > WX 200-225 Clinical departments and units
WJ Urogenital system > WJ 140-160 Urologic diseases
WO Surgery > WO 500-517 Operative surgical procedures. Techniques
WJ Urogenital system > WJ 700-875 Male genitalia
WP Gynaecology > WP 440-468 Uterine diseases
WJ Urogenital system > WJ 400-600 Ureter. Bladder. Urethra
WJ Urogenital system > WJ 300-378 Kidney
Language:German
Series Name:HTA-Projektbericht 84
Deposited on:02 Dec 2015 13:16
Last Modified:04 Apr 2016 13:05

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