A systematic review of full economic evaluations of robotic-assisted surgery in thoracic and abdominopelvic procedures

Abstract

This study aims to conduct a systematic review of full economic analyses of robotic-assisted surgery (RAS) in adults' thoracic and abdominopelvic indications. Authors used Medline, EMBASE, and PubMed to conduct a systematic review following the preferred reporting items for systematic reviews and meta‐analyses (PRISMA) 2020 guidelines. Fully published economic articles in English were included. Methodology and reporting quality were assessed using standardized tools. Majority of studies (28/33) were on oncology procedures. Radical prostatectomy was the most reported procedure (16/33). Twenty-eight studies used quality-adjusted life years, and five used complication rates as outcomes. Nine used primary and 24 studies used secondary data. All studies used modeling. In 81% of studies (27/33), RAS was cost-effective or potentially cost-effective compared to comparator procedures, including radical prostatectomy, nephrectomy, and cystectomy. Societal perspective, longer-term time-horizon, and larger volumes favored RAS. Cost-drivers were length of stay and equipment cost. From societal and payer perspectives, robotic-assisted surgery is a cost-effective strategy for thoracic and abdominopelvic procedures.Clinical trial registration This study is a systematic review with no intervention, not a clinical trial.

Exploring the Evolution of Robotic Surgery in Obstetrics and Gynecology: Past, Present, and Future Perspectives

“…Economic considerations, including the high cost of robotic surgery equipment, pose barriers to widespread adoption, with upfront expenses being a concern for many healthcare facilities [47]. Surgeons must undergo extensive training to become proficient in robotic surgery techniques, which can impact patient safety during the learning curve [48].…”

Initial experience with robotic technology for thoracic surgery using the da Vinci Xi system in Tibet, China

“…With high altitude and relatively harsh natural environment, the traditional surgery in Tibet face greater risks and challenges. Through robotic surgery, doctors can operate surgical instruments more accurately, reduce injuries and bleeding during surgery, thus reducing the risk of surgery and improving the success rate of surgery ( 4 ). Meanwhile, robot surgery can assist surgeons to perform more complicated operations, improve the quality of surgery, and make more efficient use of limited medical resources.…”