Alexandra Vappereau - Academia.edu (original) (raw)
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Papers by Alexandra Vappereau
Research Square (Research Square), Apr 2, 2024
Background Hysterectomy for benign pathologies is one of the most common gynecological surgeries.... more Background Hysterectomy for benign pathologies is one of the most common gynecological surgeries. In recent years, robotic surgery has become an alternative to traditional surgery, but at a higher cost. Objective Estimate the cost of benign robot-assisted hysterectomy for the purpose of supporting public decisionmaking, as well as the additional cost per major postoperative complication (ClavienDindo score ≥ 3) avoided one month after surgery robotic versus traditional laparoscopic. Methods Single-center retrospective study including patients operated on for benign hysterectomy at La Pitié Salpêtrière hospital between January 2016 and December 2019 : 99 by robotic approach, and 86 by laparoscopic approach. Comparison of robotic surgery to laparoscopy. Calculation of a costeffectiveness ratio (ICER). Use of the propensity score inverse weighting method to ensure comparability of groups. Results Robotic surgery has a total cost of € 6,615 at 1 month per patient compared to € 3,859 for laparoscopic surgery with an additional cost of € 377,534 per major postoperative complication avoided, longer operating time and an absence of signi cant difference in terms of complications and length of hospitalization. Conclusion In terms of cost-effectiveness, according to this study, the robot does not appear to be better than laparoscopy. In the years to come, we can expect a development of robotic surgery with rationalization of the practice, with appropriate selection of patients for robotic surgery, development of outpatient surgery and a reduction in the cost of the equipment.
Value in Health, Dec 1, 2022
Research Square (Research Square), Apr 2, 2024
Background Hysterectomy for benign pathologies is one of the most common gynecological surgeries.... more Background Hysterectomy for benign pathologies is one of the most common gynecological surgeries. In recent years, robotic surgery has become an alternative to traditional surgery, but at a higher cost. Objective Estimate the cost of benign robot-assisted hysterectomy for the purpose of supporting public decisionmaking, as well as the additional cost per major postoperative complication (ClavienDindo score ≥ 3) avoided one month after surgery robotic versus traditional laparoscopic. Methods Single-center retrospective study including patients operated on for benign hysterectomy at La Pitié Salpêtrière hospital between January 2016 and December 2019 : 99 by robotic approach, and 86 by laparoscopic approach. Comparison of robotic surgery to laparoscopy. Calculation of a costeffectiveness ratio (ICER). Use of the propensity score inverse weighting method to ensure comparability of groups. Results Robotic surgery has a total cost of € 6,615 at 1 month per patient compared to € 3,859 for laparoscopic surgery with an additional cost of € 377,534 per major postoperative complication avoided, longer operating time and an absence of signi cant difference in terms of complications and length of hospitalization. Conclusion In terms of cost-effectiveness, according to this study, the robot does not appear to be better than laparoscopy. In the years to come, we can expect a development of robotic surgery with rationalization of the practice, with appropriate selection of patients for robotic surgery, development of outpatient surgery and a reduction in the cost of the equipment.
Value in Health, Dec 1, 2022