title: Cost assessment of robotics in gynecologic surgery: a systematic review.
abstract: OBJECTIVE
  The application of robotics is an innovation in the field of gynecologic surgery. Our objective was to evaluate the currently available literature on the cost assessment of robotic surgery of various operations in the field of gynecologic surgery.
  
  
  METHODS
  PubMed and Scopus databases were systematically searched in order to retrieve the included studies in our review.
  
  
  RESULTS
  We retrieved 23 studies on a variety of gynecologic operations. The mean cost for robotic, open and laparoscopic surgery ranged from 1731 to 48,769, 894 to 20,277 and 411 to 41,836 Euros, respectively. Operative charges, in hysterectomy, for robotic, open and laparoscopic technique ranged from 936 to 33,920, 684 to 25,616 and 858 to 25,578 Euros, respectively. In sacrocolpopexy, these costs ranged from 2067 to 7275, 2904 to 69,792 and 1482 to 2000 Euros, respectively. Non-operative charges ranged from 467 to 39,121 Euros. The mean total costs for myomectomy ranged from 27,342 to 42,497 and 13,709 to 20,277 Euros, respectively, for the robotic and open methods, while the mean total cost of the laparoscopic technique was 26,181 Euros. Conversions to laparotomy were present in 79/36,185 (0.2%) cases of laparoscopic surgery and in 21/3345 (0.62%) cases of robotic technique. Duration of robotic, open and laparoscopic surgery ranged from 50 to 445, 83.7 to 701 and 74 to 330 min, respectively.
  
  
  CONCLUSIONS
  Robotic surgery has the potential to become cost-effective in centers with many patients while industry competition could reduce the cost of the robotic instrumentation, making robotic technology more affordable and cost-effective.
authors.affiliation: Robotic Gynaecology and Gynaecological Oncology Department, Christie Hospital, Manchester, UK.
authors.forename: Christos
authors.initials: C
authors.lastname: Iavazzo
authors.forename: Eleni K
authors.initials: EK
authors.lastname: Papadopoulou
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Gkegkes
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000191:economics / Q000295:instrumentation*; D017048:Health Care Costs; D017721:Hospital Costs; D006801:Humans; D065287:Robotic Surgical Procedures / Q000191:economics*
keywords: cost; gynecology; health-care economics; outcome; robotics; training