Introducing robotic surgery into an endometrial cancer service–a prospective evaluation of clinical and economic outcomes in a UK institution

BACKGROUND: We have assessed how the introduction of robotics in a publicly funded endometrial cancer service affects clinical and economic outcomes. METHODS: The study included 196 women. Costs were divided into those for wards, high dependency, staffing, theatres, pharmacy, blood products, imaging, pathology and rehabilitation. Capital depreciation was included. RESULTS: Prior to the introduction of robotics, 78/130 (60.0%) cases were performed open, compared to 17/66 (25.8%) afterwards (p < 0.0001). The median operative time increased 37 min (95% CI 17-55 min; p = 0.0002); the median blood loss was 55 ml lower (95% CI 0-150 ml; p = 0.0181); the stay was 2 days shorter (95% CI 1-3; p < 0.0001). Complications reduced from 64/130 (49.2%) to 19/66 (28.8%) (p = 0.0045). Costs reduced from £11 476 to £10 274 (p = 0.0065). Conversions for 'straight stick' surgery were 18.2% (14/77) compared to 0.0% (0/24) for robotics (p = 0.0164). CONCLUSIONS: Introducing robotics resulted in fewer laparotomies, shorter stays, fewer complications and lower costs.