There's no way you're comparing apples to apples. I have never seen a simple hyst take 2+ hours on the robot. Was this surgeon new in their learning curve?? If so, of course it takes more time. Ask them how long their first lap or vag hyst took them. An experienced robotic surgeon is just as fast robotically, as they were laparoscopically (sometimes even faster). Other than the extra time in the OR as a surgeon goes through the learning curve, there is no added cost. Please explain where you get the added cost? Our instruments are cheaper than ligasure, Enseal, Harmonic, etc. The robot is paid for, that is not an extra cost. Drapes are cheap, so it can't be that. Reimbursement is the same as lap, so yes, it does hurt initially as the surgeon goes through the learning curve. Once they are through the learning curve the reimbursement is no different than what they are used to.
In regards to why it is better than a vag hyst, is simple: how about visualization, access, precision, better suturing of vag cuff from above (allows for a longer vagina by), less patient pain (vag hysts are very painful for the patient post op, all that tugging and pulling causes a lot of internal pain). Also, most vag surgeons struggle to remove the ovaries, so they just leave them there. If the patient is suffering from endometriosis, there is no way you can ressect it vaginally, b/c you can't see it. Also, leaving the ovaries, means that pain will soon come back. Lastly, LOS is shortened w/ robotics than w/ lap.