The “Medical Cost” of Robot-Assisted Laparoscopic Surgery in Endometrial Cancer in Terms of Anesthesia Comparison with Traditional Laparoscopic Surgery

Abstract

Objective :Minimally invasive surgeries have important advantages such as lower morbidity, shorter hospital stay, and earlier return to routine life. Robot-assisted laparoscopic surgery (RALS) plays a leading role in the development process of minimally invasive surgery. In this study, we compared patients with endometrial cancer who were operated with RALS and traditional laparoscopic surgery (TLS) methods in terms of processes related to anesthesia, such as peroperative fluid management and transfusion requirement, analgesic strategies, postoperative complications, duration of post-anesthesia care unit (PACU) and hospital stay
 Materials and Methods: Patients with American Society of Anaesthesiologists (ASA) scores II-III, over the age of 18, who were operated for endometrial cancer by TLS or RALS methods between January 2020 and March 2022 were included in the study. Patients age, ASA score, duration of surgery, peroperative fluid management, transfusion requirement, urine output, bleeding, postoperative Visual Analogue Scale (VAS) scores, the PACU admission were obtained from the standard anesthesia record form and preoperative and postoperative hemoglobin (Hb) values, length of hospital stay were obtained from the electronic database of the hospital. 
 Results: Intravenous fluid input, bleeding and urine output during the operation were statistically lower in group RALS. While there was no difference between the preoperative Hb values of the two groups, the postoperative Hb values were significantly lower in the TLS group. Perioperative bleeding and fluid replacement are lesser and the hospital stay is shorter in RALS. 
 Conclusion: TLS and RALS, which are minimally invasive surgical methods, are used in the treatment of endometrial cancer. The idea that RALS is more costly than TLS should be reconsidered, as RALS reduces costs with less perioperative bleeding and fluid replacement and shorter hospital stay