Robotic single-site versus laparoscopic cholecystectomy: Which is cheaper? A cost report and analysis

Bedeir, Kareem; Mann, Andrew W.; Youssef, Yassar

doi:10.1007/s00464-015-4203-0

Cited by 31 publications

(19 citation statements)

References 23 publications

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“…In our experience, patients undergoing elective surgery for biliary colic or chronic cholecystitis both experienced a decrease in operative time on the robotic platform. These results have been seen by other groups with shorter operative times (18,19). The effect of operative time charges must be included in any cost analysis to accurately assess the impact of this technology.…”

Section: The Cost Of Robotic Surgerymentioning

confidence: 72%

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The emerging role for robotics in cholecystectomy: the dawn of a new era?

Zaman¹,

Singh²

2018

Hepatobiliary Surg. Nutr.

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Though laparoscopic cholecystectomy (LC) was highly criticized in its early stages, it quickly grew to become a new standard of care and has revolutionized the field of general surgery. Now emerging robotic technology is making its way into the minimally invasive arena. Robotic cholecystectomy (RC) is often disparaged as a costly technology that can lead to increased operative times with outcomes that are quite similar to LC. However, this perspective is skewed as many existing studies were performed in the early phase of learning for this procedure. RC can be performed in a cost-effective manner as the volume of robotic procedures increases. In addition, improved visualization and capability to perform fluorescence cholangiography can improve the safety profile of cholecystectomy to a level that has not yet been achieved with conventional laparoscopy. Advanced simulation technology for robotic surgery, and newer singlesite robotic platforms have the potential to further revolutionize this technology and lead to improved patient satisfaction. In this review, we will present current data, trends, and controversies in robotic-assisted cholecystectomy.

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Section: The Cost Of Robotic Surgerymentioning

confidence: 72%

“…Alternatively, a recent retrospective study of single-site robotic cholecystectomy (SSRC) demonstrated a decrease in median hospital cost ($1,319 SSRC vs. $1,710 LC) (18). Costs were contained by limiting non-essential instruments from standard trays and avoiding disposable items such as a retrieval bag for the specimen.…”

Section: The Cost Of Robotic Surgerymentioning

confidence: 99%

The emerging role for robotics in cholecystectomy: the dawn of a new era?

Zaman¹,

Singh²

2018

Hepatobiliary Surg. Nutr.

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“…In hospitals with an established infrastructure for robotic surgery, there is potential for cost efficacy. In a review from one institution, overall savings from supplies and instruments and shortened operating room times resulted in robotic single-site laparoscopic cholecystectomy being more cost effective than laparoscopic cholecystectomy [53]. When comparing cost margin only at a private community hospital, there was no difference in cost between robotic and laparoscopic cholecystectomy [54].…”

Section: Costmentioning

confidence: 99%

Robotic Approach to Cholecystectomy

Barrera¹,

Sugiyama²

2017

Updates in Gallbladder Diseases

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Cholecystectomy is one of the most commonly performed abdominal procedures with more than 600,000 performed annually in the United States. Laparoscopic cholecystectomy, first introduced in the 1980s, offered faster recovery time and a more cosmetic result making it the more favorable approach. In developed countries, up to 90% of cholecystectomies are done via laparoscopy. After the first robotic surgery platform was approved by the FDA in 2000, it provided surgeons with enhanced ergonomic capabilities and visualization and also offered possibility of telemedicine. The first series of robotic cholecystectomies soon followed in the last 15 years, and robotic cholecystectomy has become increasingly popular and has been established as a safe approach. The aims of this chapter are to address the history of robotic-assisted cholecystectomy, the technical aspects of multiport and single-port approaches, use of cholangiography, demonstration of safety and use in both community and academic settings.

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“…The top down analysis found a minimum additional cost of $2,600 per procedure (43) while the instrument price examination found equal instrument costs (19). Two studies found no significant difference (19,44) or minor savings of $391 dollars (45).…”

Section: Analysis Of Rcmentioning

confidence: 99%

“…Similarly, Bedeir et al evaluated 177 robotic and 281 laparoscopic cholecystectomies from 2012 to 2014 (45). The median total costs for RC were significantly lower than the laparoscopic technique (robot: $1,319; laparoscopic: $1,710).…”

Section: Rcmentioning

confidence: 99%

Value-based assessment of robotic pancreas and liver surgery

Patti

Ore

Barrows

et al. 2017

Hepatobiliary Surg. Nutr.

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Current healthcare economic evaluations are based only on the perspective of a single stakeholder to the healthcare delivery process. A true value-based decision incorporates all of the outcomes that could be impacted by a single episode of surgical care. We define the value proposition for robotic surgery using a stakeholder model incorporating the interests of all groups participating in the provision of healthcare services: patients, surgeons, hospitals and payers. One of the developing and expanding fields that could benefit the most from a complete value-based analysis is robotic hepatopancreaticobiliary (HPB) surgery. While initial robot purchasing costs are high, the benefits over laparoscopic surgery are considerable. Performing a literature search we found a total of 18 economic evaluations for robotic HPB surgery. We found a lack of evaluations that were carried out from a perspective that incorporates all of the impacts of a single episode of surgical care and that included a comprehensive hospital cost assessment. For distal pancreatectomies, the two most thorough examinations came to conflicting results regarding total cost savings compared to laparoscopic approaches. The most thorough pancreaticoduodenectomy evaluation found non-significant savings for total hospital costs. Robotic hepatectomies showed no cost savings over laparoscopic and only modest savings over open techniques. Lastly, robotic cholecystectomies were found to be more expensive than the gold-standard laparoscopic approach. Existing cost accounting data associated with robotic HPB surgery is incomplete and unlikely to reflect the state of this field in the future. Current data combines the learning curves for new surgical procedures being undertaken by HPB surgeons with costs derived from a market dominated by a single supplier of robotic instruments. As a result, the value proposition for stakeholders in this process cannot be defined. In order to solve this problem, future studies must incorporate (I) quality of life, survival, and return to independent function alongside data such as (II) intent-to-treat analysis of minimally-invasive surgery accounting for conversions to open, (III) surgeon and institution experience and operative time as surrogates for the learning curve; and (IV) amortization and maintenance costs as well as direct costs of disposables and instruments.

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Robotic single-site versus laparoscopic cholecystectomy: Which is cheaper? A cost report and analysis

Cited by 31 publications

References 23 publications

The emerging role for robotics in cholecystectomy: the dawn of a new era?

The emerging role for robotics in cholecystectomy: the dawn of a new era?

Robotic Approach to Cholecystectomy

Value-based assessment of robotic pancreas and liver surgery

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