Robotic surgery is criticized for its cost. Most studies evaluating costs are limited to the initial robotic cases performed. We sought to determine if costs decrease with an increase in experience.METHODS:
In this retrospective cohort study at a community teaching hospital, the total cost of the first 20 robotic-assisted hysterectomies performed for endometrial cancer by a single surgeon (Group 1) were compared to 20 comparable cases by the same surgeon five years later (Group 2). Data was abstracted from charts and accounting records using direct costs to the hospital. To adjust for inflation, mean operating room and anesthesia costs per minute for Group 1 were adjusted to the mean costs per minute for Group 2. The cost of supplies for Group 1 was adjusted from the 2010 to the 2015 Consumer Price Index.RESULTS:
Age, BMI, and uterine weight were comparable between the groups. Mean total cost decreased (Group 1=$10,584±1475; Group 2=$8,907±2,284; P=.009) and mean total operative costs decreased (Group 1=$9,729±1284; Group 2=$8,304±1788; P=.007) over the 5 year period. Significant reductions in operating room cost, anesthesia cost, procedure time, and operating room time were seen. However, non-operative costs, cost of supplies, surgeon's charge, and estimated blood loss were similar between the two groups.CONCLUSION:
Experience over 5 years with robotic-assisted hysterectomies is associated with a significant reduction in cost. This cost reduction is primarily attributable to shorter procedure time and operation room time.