Observational studyBMJ open2023
Robotic and laparoscopic gynaecological surgery: a prospective multicentre observational cohort study and economic evaluation in England.
Observational study in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.
- Robotic versus laparoscopic and open surgery for endometrial cancer: a systematic review of randomized trials and pooled analysis of conversion rates.Journal of robotic surgery · 2026Pooled it
- Quality of life after robotic versus conventional minimally invasive cancer surgery: a systematic review and meta-analysis.Journal of robotic surgery · 2024Pooled it
- Comparison of European regionwide and Japanese nationwide surveys on gynecologic robotic surgery.Journal of robotic surgery · 2026Article
- A bibliometric analysis of minimally invasive esophagectomy for esophageal cancer (2005-2024): mapping the knowledge landscape and future trends.Surgical endoscopy · 2026Article
- Transvaginal sonography-guided aspiration of benign ovarian cysts: a retrospective evaluation of safety, feasibility, and economic and environmental implications.Archives of gynecology and obstetrics · 2026Article
- Team-based learning curve and cost efficiency in robot-assisted hysterectomy: a four-phase CUSUM study of 915 cases.Journal of robotic surgery · 2025Article
- Current status and prospects of robotic surgery adoption in obstetrics and gynecology: insights from a nationwide survey.Journal of robotic surgery · 2025Article
- Economic Evaluations of Robotic-Assisted Surgery: Methods, Challenges and Opportunities.Applied health economics and health policy · 2025Review
- Robot Assisted Laparoscopic Surgery in Gynaecology: An Evolving Assistive Technology.Surgical innovation · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the health-related quality of life and cost-effectiveness of robot-assisted laparoscopic surgery (RALS) versus conventional 'straight stick' laparoscopic surgery (CLS) in women undergoing hysterectomy as part of their treatment for either suspected or proven gynaecological malignancy.
designMulticentre prospective observational cohort study.
settingPatients aged 16+ undergoing hysterectomy as part of their treatment for gynaecological malignancy at 12 National Health Service (NHS) cancer units and centres in England between August 2017 and February 2020.
participants275 patients recruited with 159 RALS, 73 CLS eligible for analysis. OUTCOME MEASURES: Primary outcome was the European Organisation for Research and Treatment of Cancer Quality of Life measure (EORTC). Secondary outcomes included EuroQol-5 Dimension (EQ-5D-5L) utility, 6-minute walk test (6MWT), NHS costs using pounds sterling (£) 2018-2019 prices and cost-effectiveness. The cost-effectiveness evaluation compared EQ-5D-5L quality adjusted life years and costs between RALS and CLS.
resultsNo difference identified between RALS and CLS for EORTC, EQ-5D-5L utility and 6MWT. RALS had unadjusted mean cost difference of £556 (95% CI -£314 to £1315) versus CLS and mean quality adjusted life year (QALY) difference of 0.0024 (95% CI -0.00051 to 0.0057), non-parametric incremental cost-effectiveness ratio of £231 667per QALY. For the adjusted cost-effectiveness analysis, RALS dominated CLS with a mean cost difference of -£188 (95% CI -£1321 to £827) and QALY difference of 0.0024 (95% CI -0.0008 to 0.0057).
conclusionsFindings suggest that RALS versus CLS in women undergoing hysterectomy (after adjusting for differences in morbidity) is cost-effective with lower costs and QALYs. Results are highly sensitive to the usage of robotic hardware with higher usage increasing the probability of cost-effectiveness. Non-inferiority randomised controlled trial would be of benefit to decision-makers to provide further evidence on the cost-effectiveness of RALS versus CLS but may not be practical due to surgical preferences of surgeons and the extensive roll out of RALS.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.