In addition, robotic surgery, in high demand among patients, can lose money for hospitals because of its expense and special training required, according to the new review of studies by ECRI, a nonprofit health services research agency that produces systematic evidence reviews on medical devices, drugs, biotechnologies, procedures and behavioural health services.

The review of 625 cases looks at two studies that compared the three procedures available to patients: traditional open surgery, laparoscopic surgery and robotic-assisted laparoscopic surgery.

In the review, average blood loss was significantly lower for patients who underwent either of the two minimally invasive procedures: less than 150 ml for robotic-assisted and 382 ml for non-robotic, while the average blood loss for open radical surgery in the two studies was 418 ml and 910 ml.

Cancer cure rate, measured by presence of cancerous cells at the surface of the removed prostate, and by PSA levels following surgery, was nearly identical for all three procedures.

Hospital stay was significantly shorter with robotic-assisted prostatectomy compared to open surgery in both studies, 25.9 hours versus 52.8 hours in one study. One study reported significant difference in catheterisation time: seven days for robotic-assisted patients, 7.9 days for non-robotic laparoscopy patients and 15.8 days for open surgery patients.

Open prostatectomy had a significantly higher overall complication rate of 15 percent, while non-robotic laparoscopic prostatectomy had a rate of ten percent and robotic-assisted had a complication rate of five percent.

According to the review, “shorter operative time and decreased hospital stays associated with the robotic procedure did not make up for the cost of the additional equipment expenditure.” Estimated costs of the robotic system to a provider run about $1.2 million a year, with maintenance costs of $120,000 a year and one-time costs of $1,500 a case.; Source: Health Behavior News Service