Are they safer? Are they cost-effective? Here is a summary from Jason Shafrin (gated):
Several observational studies have shown that compared to open surgeries, laparoscopic surgeries had fewer respiratory, miscellaneous surgical and anastomotic stricture complications in radical prostatectomy (Hu et al. 2009; Hu et al. 2008; Shih et al. 2012) However, it has also been shown that [robot-assisted radical prostatectomies] RARPs were associated with higher rates of genitourinary complications than open surgery.(Hu et al. 2009; Prasad et al. 2010) In addition, the shorter [length of stay] LOS highly publicized by Intuitive Surgical does not necessarily imply cost-saving. In fact, due to longer time spent in operation room, hospitalizations for [minimally invasive radical prostatectomy] MIRP were found to be more costly than those for [open prostatectomy] ORP. A systematic review on the cost of radical prostatectomy concluded that the cost of laparoscopic surgery was $2000 – $4000 higher than that of open surgery;(Bolenz et al. 2012) similar findings were also found in a population-based study using commercial claims data.(Shih et al. 2012) It was estimated that robotic surgery alone added $4 million to Medicare expenditures on prostate cancer.(Nguyen et al. 2011) Therefore, whether the net benefit…associated with the wide diffusion of robotic-assisted surgeries remains inclusive.