Does Robotic Technology Make Minimally Invasive Cardiac Surgery Too Expensive? A Hospital Cost Analysis of Robotic and Conventional Techniques

Abstract

Robotic technology did not significantly increase hospital cost. While the absolute cost for robotic surgery was higher than conventional techniques after taking into account the institutional cost of the robot, the major driver of cost for robotic procedures will likely continue to decrease, as the surgical team becomes increasingly familiar with robotic technology. Furthermore, other benefits, such as improvement in postoperative quality of life and more expeditious return to work may make a robotic approach cost-effective. Thus, it is possible that the benefits of robotic surgery may justify investment in this technology.

Robotic surgery

“…When leaving out the initial capital investment for the robotic system, there was no significant difference in costs between the robot procedure and the sternotomy procedure. 141 Most cost analyses have been performed for radical prostatectomy. The cost of the open conventional laparoscopic and robot-assisted radical prostatectomy has been compared by different groups.…”

Do Costs of Robotic Surgery Matter?

“…Therefore the crucial question is whether robotic surgery, being more expensive, is better than comparable traditional video-endoscopic and open surgery. Generally most robotic and laparoscopic procedures have less short term morbidity, blood loss, intensive care unit and hospital stay then open surgery (6,11,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Up to now no major differences have been found between robot-assisted and classic videoassisted procedures for these factors.…”

“…Mean hospital cost, without including capital costs, was comparable (18503 AUD vs 17880 AUD, p=0.176). Morgan and colleagues conducted a retrospective review of clinical and financial data of 20 patients undergoing atrial septal defect closure, and 20 patients who underwent mitral valve repair (MVR) using either robotic techniques or a conventional approach by sternotomy (34). Robotics did not significantly increase the total hospital cost for ASD closure or MVR.…”

Robotic cardiac surgery

“…The system is very expensive and the robotic surgical instruments have a fixed usage life of 10 procedures per instrument (30). Difficult to assess is the offset of these costs due to shorter ICU and hospital stays.…”