Outpatient robotic hysterectomy: Clinical outcomes and financial analysis of initial experience

Background: Robotic surgery is associated with several advantages but also high costs. This study evaluates clinical outcomes and financial feasibility of outpatient robotic hysterectomy. Methods: Retrospective cohort study (Class II-2) of patients who underwent robotic hysterectomy for benign conditions by the same surgeon (M.A.B.) at the University of Texas Medical Branch, Galveston, TX, USA, during November 2010-February 2013. The study only included cases considered appropriate for outpatient management. Clinical outcomes and costs for patients discharged the same day (outpatients) were compared to those electively admitted (hospitalized). Results: Twenty-nine cases (14 outpatient and 15 hospitalized) were analysed. Demographic, pre-, peri- and postoperative characteristics and payer types were not different among the groups (p > 0.05). Outpatient hysterectomy was associated with $4968 hospital savings (p < 0.001), $410 payer savings (p = 0.775) and $4558 improvement in net profit/loss (p = 0.01). Conclusions: In well-selected patients, adopting a well-designed programme, outpatient robotic hysterectomy seems to be safe and financially feasible.