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,...
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| Veröffentlicht in: | The international journal of medical robotics + computer assisted surgery 2016-03, Vol.12 (1), p.137-144 |
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| container_title | The international journal of medical robotics + computer assisted surgery |
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| creator | Ind, Thomas E. J. Marshall, Chris Hacking, Matthew Harris, Michelle Bishop, Liz Barton, Desmond Bridges, Jane E. Shepherd, John H. Nobbenhuis, Marielle |
| description | 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 |
| doi_str_mv | 10.1002/rcs.1651 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6680287</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1800479642</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5571-80d0d7e446039524e55dd2f544cf000d3548dff2596f2c0ce68d9c6f4b1bf0b63</originalsourceid><addsrcrecordid>eNqFkl1rFDEUhgdRbK2Cv0AC3ngzNcnkY-ZGkEVrP1RoLXoXssmZNXUm2SaZ1f0R_udm7bp-gHh1AnnOQ86bU1WPCT4kGNPn0aRDIji5U-0TJtuad-LT3d2Zk73qQUpXGDPOBLtf7VHe0oZJul99P_Y5BjsZ5xcohnnIzqA0xQXENXI-B6Q9Am_DCDk6PSCjvYGIEsSVM1BrtIwhLcFktwIEKz1MOrvgUeiRGZx3pvRobxGY4MNY5GHKpthSsSONLk9LTdnladP1sLrX6yHBo209qC5fv_owe1OfvT86nr08qw3nktQttthKYEzgpuOUAefW0p4zZnqMsW04a23f0xJDTw02IFrbGdGzOZn3eC6ag-rFrXc5zUewBkoIelDL6EYd1ypop_688e6zWoSVEqLFtJVF8GwriOF6gpTV6JKBYdAewpQUaUvYshOM_h-VEreyo7wp6NO_0KswRV-S-EGRjjEqfglNST5F6HfvJlht1kGVdVCbdSjok9_n3IE__78A9S3w1Q2w_qdInc8utsIt71KGbztexy9KyEZy9fHdkXp7fkE7dtKqk-YG8ufQ0A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1770194426</pqid></control><display><type>article</type><title>Introducing robotic surgery into an endometrial cancer service-a prospective evaluation of clinical and economic outcomes in a UK institution</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Ind, Thomas E. J. ; Marshall, Chris ; Hacking, Matthew ; Harris, Michelle ; Bishop, Liz ; Barton, Desmond ; Bridges, Jane E. ; Shepherd, John H. ; Nobbenhuis, Marielle</creator><creatorcontrib>Ind, Thomas E. J. ; Marshall, Chris ; Hacking, Matthew ; Harris, Michelle ; Bishop, Liz ; Barton, Desmond ; Bridges, Jane E. ; Shepherd, John H. ; Nobbenhuis, Marielle</creatorcontrib><description>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. © 2015 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery Published by John Wiley & Sons Ltd.</description><identifier>ISSN: 1478-5951</identifier><identifier>EISSN: 1478-596X</identifier><identifier>DOI: 10.1002/rcs.1651</identifier><identifier>PMID: 25823472</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Blood ; Cancer ; complications ; Costs ; economic evaluation ; Economics ; endometrial cancer ; Endometrial Neoplasms - surgery ; Female ; Health Care Costs ; Humans ; laparoscopy ; Length of Stay ; Medical ; Middle Aged ; Operative Time ; Original ; Prospective Studies ; Rehabilitation ; robotic surgery ; Robotic Surgical Procedures - economics ; Robotic Surgical Procedures - methods ; Robotics ; Telesurgery</subject><ispartof>The international journal of medical robotics + computer assisted surgery, 2016-03, Vol.12 (1), p.137-144</ispartof><rights>2015 The Authors. Published by John Wiley & Sons Ltd.</rights><rights>2015 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2016 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5571-80d0d7e446039524e55dd2f544cf000d3548dff2596f2c0ce68d9c6f4b1bf0b63</citedby><cites>FETCH-LOGICAL-c5571-80d0d7e446039524e55dd2f544cf000d3548dff2596f2c0ce68d9c6f4b1bf0b63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Frcs.1651$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Frcs.1651$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1416,27915,27916,45565,45566</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25823472$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ind, Thomas E. J.</creatorcontrib><creatorcontrib>Marshall, Chris</creatorcontrib><creatorcontrib>Hacking, Matthew</creatorcontrib><creatorcontrib>Harris, Michelle</creatorcontrib><creatorcontrib>Bishop, Liz</creatorcontrib><creatorcontrib>Barton, Desmond</creatorcontrib><creatorcontrib>Bridges, Jane E.</creatorcontrib><creatorcontrib>Shepherd, John H.</creatorcontrib><creatorcontrib>Nobbenhuis, Marielle</creatorcontrib><title>Introducing robotic surgery into an endometrial cancer service-a prospective evaluation of clinical and economic outcomes in a UK institution</title><title>The international journal of medical robotics + computer assisted surgery</title><addtitle>Int J Med Robotics Comput Assist Surg</addtitle><description>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. © 2015 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery Published by John Wiley & Sons Ltd.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood</subject><subject>Cancer</subject><subject>complications</subject><subject>Costs</subject><subject>economic evaluation</subject><subject>Economics</subject><subject>endometrial cancer</subject><subject>Endometrial Neoplasms - surgery</subject><subject>Female</subject><subject>Health Care Costs</subject><subject>Humans</subject><subject>laparoscopy</subject><subject>Length of Stay</subject><subject>Medical</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Original</subject><subject>Prospective Studies</subject><subject>Rehabilitation</subject><subject>robotic surgery</subject><subject>Robotic Surgical Procedures - economics</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Robotics</subject><subject>Telesurgery</subject><issn>1478-5951</issn><issn>1478-596X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNqFkl1rFDEUhgdRbK2Cv0AC3ngzNcnkY-ZGkEVrP1RoLXoXssmZNXUm2SaZ1f0R_udm7bp-gHh1AnnOQ86bU1WPCT4kGNPn0aRDIji5U-0TJtuad-LT3d2Zk73qQUpXGDPOBLtf7VHe0oZJul99P_Y5BjsZ5xcohnnIzqA0xQXENXI-B6Q9Am_DCDk6PSCjvYGIEsSVM1BrtIwhLcFktwIEKz1MOrvgUeiRGZx3pvRobxGY4MNY5GHKpthSsSONLk9LTdnladP1sLrX6yHBo209qC5fv_owe1OfvT86nr08qw3nktQttthKYEzgpuOUAefW0p4zZnqMsW04a23f0xJDTw02IFrbGdGzOZn3eC6ag-rFrXc5zUewBkoIelDL6EYd1ypop_688e6zWoSVEqLFtJVF8GwriOF6gpTV6JKBYdAewpQUaUvYshOM_h-VEreyo7wp6NO_0KswRV-S-EGRjjEqfglNST5F6HfvJlht1kGVdVCbdSjok9_n3IE__78A9S3w1Q2w_qdInc8utsIt71KGbztexy9KyEZy9fHdkXp7fkE7dtKqk-YG8ufQ0A</recordid><startdate>201603</startdate><enddate>201603</enddate><creator>Ind, Thomas E. J.</creator><creator>Marshall, Chris</creator><creator>Hacking, Matthew</creator><creator>Harris, Michelle</creator><creator>Bishop, Liz</creator><creator>Barton, Desmond</creator><creator>Bridges, Jane E.</creator><creator>Shepherd, John H.</creator><creator>Nobbenhuis, Marielle</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>BSCLL</scope><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7SC</scope><scope>7SP</scope><scope>7TB</scope><scope>8FD</scope><scope>F28</scope><scope>FR3</scope><scope>JQ2</scope><scope>K9.</scope><scope>L7M</scope><scope>L~C</scope><scope>L~D</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201603</creationdate><title>Introducing robotic surgery into an endometrial cancer service-a prospective evaluation of clinical and economic outcomes in a UK institution</title><author>Ind, Thomas E. J. ; Marshall, Chris ; Hacking, Matthew ; Harris, Michelle ; Bishop, Liz ; Barton, Desmond ; Bridges, Jane E. ; Shepherd, John H. ; Nobbenhuis, Marielle</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5571-80d0d7e446039524e55dd2f544cf000d3548dff2596f2c0ce68d9c6f4b1bf0b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood</topic><topic>Cancer</topic><topic>complications</topic><topic>Costs</topic><topic>economic evaluation</topic><topic>Economics</topic><topic>endometrial cancer</topic><topic>Endometrial Neoplasms - surgery</topic><topic>Female</topic><topic>Health Care Costs</topic><topic>Humans</topic><topic>laparoscopy</topic><topic>Length of Stay</topic><topic>Medical</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Original</topic><topic>Prospective Studies</topic><topic>Rehabilitation</topic><topic>robotic surgery</topic><topic>Robotic Surgical Procedures - economics</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Robotics</topic><topic>Telesurgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ind, Thomas E. J.</creatorcontrib><creatorcontrib>Marshall, Chris</creatorcontrib><creatorcontrib>Hacking, Matthew</creatorcontrib><creatorcontrib>Harris, Michelle</creatorcontrib><creatorcontrib>Bishop, Liz</creatorcontrib><creatorcontrib>Barton, Desmond</creatorcontrib><creatorcontrib>Bridges, Jane E.</creatorcontrib><creatorcontrib>Shepherd, John H.</creatorcontrib><creatorcontrib>Nobbenhuis, Marielle</creatorcontrib><collection>Istex</collection><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Online Library Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Computer and Information Systems Abstracts</collection><collection>Electronics & Communications Abstracts</collection><collection>Mechanical & Transportation Engineering Abstracts</collection><collection>Technology Research Database</collection><collection>ANTE: Abstracts in New Technology & Engineering</collection><collection>Engineering Research Database</collection><collection>ProQuest Computer Science Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>Computer and Information Systems Abstracts Academic</collection><collection>Computer and Information Systems Abstracts Professional</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The international journal of medical robotics + computer assisted surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ind, Thomas E. J.</au><au>Marshall, Chris</au><au>Hacking, Matthew</au><au>Harris, Michelle</au><au>Bishop, Liz</au><au>Barton, Desmond</au><au>Bridges, Jane E.</au><au>Shepherd, John H.</au><au>Nobbenhuis, Marielle</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Introducing robotic surgery into an endometrial cancer service-a prospective evaluation of clinical and economic outcomes in a UK institution</atitle><jtitle>The international journal of medical robotics + computer assisted surgery</jtitle><addtitle>Int J Med Robotics Comput Assist Surg</addtitle><date>2016-03</date><risdate>2016</risdate><volume>12</volume><issue>1</issue><spage>137</spage><epage>144</epage><pages>137-144</pages><issn>1478-5951</issn><eissn>1478-596X</eissn><abstract>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. © 2015 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery Published by John Wiley & Sons Ltd.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>25823472</pmid><doi>10.1002/rcs.1651</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1478-5951 |
| ispartof | The international journal of medical robotics + computer assisted surgery, 2016-03, Vol.12 (1), p.137-144 |
| issn | 1478-5951 1478-596X |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Aged, 80 and over Blood Cancer complications Costs economic evaluation Economics endometrial cancer Endometrial Neoplasms - surgery Female Health Care Costs Humans laparoscopy Length of Stay Medical Middle Aged Operative Time Original Prospective Studies Rehabilitation robotic surgery Robotic Surgical Procedures - economics Robotic Surgical Procedures - methods Robotics Telesurgery |
| title | Introducing robotic surgery into an endometrial cancer service-a prospective evaluation of clinical and economic outcomes in a UK institution |
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