Re: JSLS. 2008;12(1):9-12 A da Vinci Robot System Can Make Sense for a Mature Laparoscopic Prostatectomy Program

The economics of robotic prostatectomy are very important, considering the fact that prostate cancer is the most common cancer in men and radical prostatectomy is one of the main treatments for localized disease. The rapid adoption of robotic prostatectomy has resulted in the widespread availability of robotic systems and significant utilization by surgeons with little prior laparoscopic experience.1 The study by Steinberg et al2 evaluates the potential cost-benefit of adopting the robotic approach to an established laparoscopic program. This study found that it is possible that an increase in surgical volume will result in sufficient profits to offset the added cost of the robot (purchase cost of $1.5 million plus maintenance cost) and equipment. A major requirement is that robotic prostatectomy will be profitable for a hospital and that a sufficient rise in surgical volume is achievable. The authors conclude that a high-volume laparoscopic radical prostatectomy (LRP) program can convert to robot-assisted prostatectomy (RAP) and maintain profitability but may not reach the level of LRP.