No Savings with Less Invasive Hysterectomy

The median length of stay after laparoscopic hysterectomy was 3 days in 2006 and 2007, decreasing to 2 days in the last two years of the study period.

Operative time increased substantially from 2006 through 2009. Investigators calculated operative time on the basis of total OR time, which is the method the hospital uses to determine cost per procedure. Total OR time includes prep time and other factors omitted from calculations based on “skin to skin” operating time, said Shah.

In 2006 laparoscopic procedures averaged 188 minutes, increasing to 197 minutes in 2007, 228 minutes in 2008, and 287 minutes in 2009. For each year, laparoscopic procedures lasted longer than open surgery did. However, the difference increased from 22 minutes in 2006 to 70 minutes in 2009.

Until recently, surgery for most gynecologic conditions was performed using a large abdominal incision. This is because while conventional laparoscopic surgery is effective for many routine procedures, the long-handled, rigid instruments used in laparoscopy are not usually considered effective for delicate or complex operations.

Fortunately, there is a minimally invasive option for treating gynecologic conditions designed to overcome the limits of traditional open and laparoscopic surgery – da Vinci Surgery.

If your doctor recommends a hysterectomy to treat your condition, you may be a candidate for da Vinci Surgery. Using state-of-the-art technology, a da Vinci® Hysterectomy requires only a few tiny incisions, so you can get back to your life faster.

The da Vinci System enables your doctor to perform a minimally invasive hysterectomy even for complex conditions - with enhanced vision, precision, dexterity and control. da Vinci Hysterectomy offers women many potential benefits over traditional surgery, including:

- Less pain
- Fewer complications
- Less blood loss
- Shorter hospital stay
- Low risk of wound infection
- Quicker recovery and return to normal activities

“In the beginning, we think the time difference reflected the learning curve involved with laparoscopic procedures,” said Shah. “However, the increase in operative time over the 4 years probably reflects the fact that we started to perform more complicated cases as we became more familiar and comfortable with laparoscopic techniques.”

The findings indicate that hospitals will not realize any savings from adoption of minimally invasive surgery in the near term, Shah said in conclusion. However, hospitals have the potential to accrue substantial savings over the long term.

“Emerging evidence, including some presented at this meeting, shows that some patients can be discharged on day 0,” he said. “Over the long term there is room for improvement that can help hospitals lower their costs.”

Shah had no disclosures.

Primary source: Society of Gynecologic Oncology
Source reference: Shah N, et al “The effect of a paradigm shift towards minimally invasive surgery on hospitalization costs of hysterectomy for endometrial cancer” SGO 2012; Abstract 46.

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