Post robotic investment: Cost consequences and impact on length of stay for obese women with endometrial cancer

INTRODUCTION: The aim of the study was to investigate whether robotic-assisted surgery is associated with lower incremental resource use amongst obese patients relative to non-obese patients after a Danish nationwide adoption of robotic-assisted surgery in women with early-stage endometrial cancer. This is a population-based cohort study based on registers and clinical data.MATERIAL AND METHODS: All women who underwent surgery (robotic, laparoscopic, and laparotomy) from 2008 to 2015 were included and divided according to body mass index (RESULTS: In total, 3934 women were included. The adoption of robotic-assisted surgery did not demonstrate statistically significant implications for total costs among obese women (€3417; 95% confidence interval [CI] -€854 to €7688, P = .117). Further, for obese women, a statistically significant reduction in bed days related to the index hospitalization was demonstrated (-1.9 bed days; CI -3.6 to -0.2, P = .025). For non-obese women, the adoption of robotic-assisted surgery was, however, associated with statistically significant total costs increments of €9333 (95% CI €3729 to €14936, P = .001) and no reduction in bed days related to the index hospitalization was observed (+0.9 bed days; 95% CI -0.6 to 2.3, P = .242).CONCLUSIONS: The national investment in robotic-assisted surgery for endometrial cancer seems to have more modest cost implications post-surgery for obese women. This may be partly driven by a significant reduction in bed days related to the index hospitalization among obese women, as well as reductions in subsequent hospitalizations.