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P67 Cost effectiveness of robotic versus open surgery hysterectomy and pelvic lymphadenectomy for endometrial cancer. The medico-economic study of a private hospital in athens, greece during the last decade
  1. E Karatrasoglou1,
  2. V Hatzirafail1,
  3. G Thomou1,
  4. A Paulaki2 and
  5. A Mpakas3
  1. 1Department of Gynecologic Surgery, Euroclinic Hospital
  2. 2Department of Pathological Anatomy, IASO Women’s Hospital
  3. 3Department of Anaesthesiology, Euroclinic Hospital, Athens, Greece


Introduction/Background The purpose of our study is to compare the costs of conventional open-surgery versus the robotic-assisted laparoscopy in the treatment of endometrial cancer.

Methodology 108 patients with endometrial cancer who were operated at the department of Gynaecologic Surgery of ‘’Euroclinic Hospital’’, Athens, Greece from 2010 to 2019, were randomised for this study. All women underwent hysterectomy, bilateral salpingo-oophorectomy (BSOE) and pelvic lymphadenectomy for endometrial carcinoma according to evident-based guidelines.50 patients were operated with the use of robotic system da Vinci S & Si while 58 patients were operated via laparotomy. In the hospital perspective the costs were defined by examining the medical pathway for each type of intervention Patients‘ BMI was similar for the two groups. We analysed the stage and grade of disease, the comorbidity factors, the number of lymph nodes removed and the percentage of complications (such as blood loss) and readmissions.

We defined the overall medical care cost by adding the cost of surgery, the post-operative hospital stay and/or hospitalisation within one month after surgery.

Results For endometrial cancer, the surgical procedure cost for robotic-assisted laparoscopy was €5.950 versus €4.950 for conventional laparotomy. Considering the overall medical care, the average cost of the in-patient treatment was €7.467 (median €6.302) for the robotic group (with average hospital stay of 3,12 days), compared to €8.086 (median €7.024) for the open-surgery group (with average hospital stay of 5,34 days). p value for the cost of surgeries is calculated to 0,37 while p value for the average stay is 0,00001.

Conclusion The cost of a robotic hysterectomy-BSOE-pelvic lymphadenectomy exceeds the cost of the open-surgery for endometrial cancer due to the higher cost of instruments and equipment. However, when considering overall medical care, conventional surgery for endometrial cancer is found 1,08 times more expensive than robotic-assisted surgery.

Disclosure Nothing to disclose.

Abstract P67 Figure 1

Medical overall cost (robotic vs laparotomy)

Abstract P67 Figure 2

Number of inpatient hysterectomies (robotic vs laparotomy)

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