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Surgical cost of robotic-assisted sacrocolpopexy: a comparison of two robotic platforms

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International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Importance

Robotic assistance in pelvic organ prolapse surgery can improve surgeon ergonomics and instrument dexterity compared with traditional laparoscopy but at increased costs.

Objective

To compare total costs for robotic-assisted sacrocolpopexy (RSC) between two robotic platforms at an academic medical center.

Methods

Retrospective cohort of Senhance (Ascensus) RSC between 1/1/2019 and 6/30/21 who were matched 2:1 with DaVinci (Intuitive) RSC. Primary outcome was total costs to hospital system; secondarily we evaluated cost sub-categories. Purchase costs of the robotic systems were not included. T-test, chi-square, and Fisher’s exact tests were used. A multivariable linear regression was performed to model total costs adjusting for potential confounders.

Results

The matched cohort included 75 subjects. The 25 Senhance and 50 DaVinci cases were similar overall, with mean age 60.5 ± 9.7, BMI 27.9 ± 4.7, and parity 2.5 ± 1.0. Majority were white (97.3%) and postmenopausal (86.5%) with predominantly stage III prolapse (64.9%). Senhance cases had longer OR times (Δ = 32.1 min, p = 0.01). There were no differences in concomitant procedures, intraoperative complications, or short-term postoperative complications between platforms (all p > 0.05). On univariable analysis, costs were similar (Senhance $5368.31 ± 1486.89, DaVinci $5741.76 ± 1197.20, p = 0.29). Cost subcategories (medications, supplies, etc.) were also similar (all p > 0.05). On multivariable linear regression, total cost was $908.33 lower for Senhance (p = 0.01) when adjusting for operative time, estimated blood loss, concomitant mid-urethral sling, and use of the GelPoint mini port system.

Conclusions

Despite longer operating times, total cost of robotic-assisted sacrocolpopexy was significantly lower when using the Senhance compared to the DaVinci system.

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Authors and Affiliations

  1. Division of Urogynecology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Stephanie Glass Clark & Michael Bonidie

  2. Department of Obstetrics & Gynecology, University of Connecticut Health Center, Farmington, CT, USA

    Jonathan P. Shepherd

  3. Division of Urogynecology, Allegheny Health Network, Pittsburgh, PA, USA

    Jessica C. Sassani

Authors
  1. Stephanie Glass Clark
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  2. Jonathan P. Shepherd
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  3. Jessica C. Sassani
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  4. Michael Bonidie
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Contributions

SGC: concept, design, analysis, writing; JS: study design, analysis, writing; JCS: study design, analysis, writing; MB: concept, design, analysis, writing

This work was presented at the American Urogynecologic Society/International Urogynecologic Association Scientific Meeting held June 14–18, 2022 in Austin, TX.

Corresponding author

Correspondence to Stephanie Glass Clark.

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Conflicts of interest

SGC reports no conflicts of interest. JS reports no conflicts of interest. JCS reports no conflicts of interest. MB serves as a consultant for proctoring for Intuitive Surgical.

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Glass Clark, S., Shepherd, J.P., Sassani, J.C. et al. Surgical cost of robotic-assisted sacrocolpopexy: a comparison of two robotic platforms. Int Urogynecol J 34, 87–91 (2023). https://doi.org/10.1007/s00192-022-05391-3

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  • DOI: https://doi.org/10.1007/s00192-022-05391-3

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