Performing Robotic Lobectomy and Segmentectomy: Cost, Profitability, and Outcomes

Nasir, Basil S.; Bryant, Ayesha S.; Minnich, Douglas J.; Wei, Ben; Cerfolio, Robert J.

doi:10.1016/j.athoracsur.2014.02.051

Cited by 108 publications

(98 citation statements)

References 19 publications

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“…Most complications in both genders were minor and at rates similar to those previously reported, including prolonged air leaks (28)(29)(30). Men had a higher risk in developing atrial fibrillation and other types of arrhythmias requiring intervention (P<0.05).…”

Section: Discussionsupporting

confidence: 67%

Effect of gender on perioperative outcomes after robotic-assisted pulmonary lobectomy

et al. 2016

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Background: Female gender has been associated with worse outcomes after cardiovascular surgery and critical illness. We investigated the effect of gender on perioperative outcomes following robotic-assisted pulmonary lobectomy. 44.5%; P=0.004), the most common of which, in both women and men, were prolonged air leak for ≥7 days (13.0% vs. 22.7%, P=0.03), atrial fibrillation (7.1% vs. 14.8%, P=0.04), and pneumonia (7.8% vs. 10.2%, P=0.49). Hospital length of stay (LOS) (4±0.3 vs. 5±0.5 days) was also shorter for women (P=0.02). Despite the higher postoperative complication rate in men, in-hospital mortality did not differ between genders (P=0.23). Multivariable analyses did not identify female gender as an independent predictor of post-operative complications. Conclusions: Female gender was associated with rates of intraoperative complications and of conversion to open lobectomy as low as those for men, but with better perioperative outcomes, lower risk of intraoperative bleeding, and fewer postoperative complications. Thus, robotic-assisted pulmonary lobectomy is feasible and safe for women.

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Section: Discussionsupporting

confidence: 67%

Effect of gender on perioperative outcomes after robotic-assisted pulmonary lobectomy

et al. 2016

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“…Robotic technology has some limitations that have affected adoption such as significant capital and maintenance costs (35,36), reduced operating room efficiencies, and a steep learning curve (37). For these reasons, the integration of the robotic platform into the management of complex locally advanced disease should be measured and only implemented after proven success on an adequate number of standard lobectomies before approaching more complex situation such as lobectomy after chemotherapy or lobectomy for N2 disease (38).…”

Section: Discussionmentioning

confidence: 99%

Robotic assisted lobectomy for locally advanced lung cancer

et al. 2017

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Some series report the use of video-assisted thoracic surgery (VATS) in patients with locally advanced non-small cell lung cancer (NSCLC) but, few studies describe the use of the robotic approach specifically for locally advanced disease. One potential advantage of the robotic approach over traditional VATS is the increased radicality. While the benefit of the robotic approach over open thoracotomy is directly related to reduced surgical trauma and the improved tolerability in fragile patients that have received induction treatment. In case of occult N2 disease, robotic assisted surgery can translate into a quicker recovery with improved compliance with adjuvant treatments following surgery. Technical details are reported and described. The robotic instrument technology allows sharp and controlled dissection compared to the typical blunt sweeping methods used in most VATS lobectomy techniques. The authors believe that robotic technology favors a more radical resection in the case of complex locally advanced tumors. Robotic technology has some limitations that have affected adoption such as significant capital and maintenance costs, reduced operating room efficiencies, and a steep learning curve.

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“…Furthermore robot-assisted lung surgery offers several advantages to the surgeon summarized as improved vision and more precise 1 and comfortable instrument manipulation (9,10).…”

Section: Introductionmentioning

confidence: 99%

Robotic lung cancer surgery: review of experience and costs

et al. 2017

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Use of robot-assisted techniques is growing fast in several surgical disciplines, now including thoracic surgery. The paper reviews experience of robotic surgery to resect lung cancer and in particular analyzes data on the costs of these procedures in comparison to open surgery and video-assisted thoracoscopic surgery (VATS). Retrospective studies published over 14 years show that robotic surgery for lung cancer has the advantages of minimally invasive surgery for patients, and some advantages over VATS for the surgeon. Limited data indicate that oncological outcomes are comparable with those of VATS and open surgery, while lymph node dissection may be more radical. Other studies indicate that robotic surgery for lung cancer offers no advantages either in terms of costs or outcomes. The high costs of purchase, maintenance and consumables are a concern and continue to limit uptake of robot systems in thoracic surgery. Most studies-but not all-indicate that robotic surgery for lung cancer is more expensive than VATS and open surgery. However limited data also indicate that hospitals can make a profit from robotic thoracic surgery, as costs seem to be lower than reimbursements from paying bodies. Nevertheless robotic thoracic surgery is still too expensive for many public hospitals, particularly in low income countries. Entry of new surgical robot manufacturers onto the market will bring much-needed competition that may also lead to cost reduction.

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Performing Robotic Lobectomy and Segmentectomy: Cost, Profitability, and Outcomes

Cited by 108 publications

References 19 publications

Effect of gender on perioperative outcomes after robotic-assisted pulmonary lobectomy

Effect of gender on perioperative outcomes after robotic-assisted pulmonary lobectomy

Robotic assisted lobectomy for locally advanced lung cancer

Robotic lung cancer surgery: review of experience and costs

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