Robotic surgery trends in general surgical oncology from the National Inpatient Sample

Stewart, Camille L.; Ituarte, Philip H.G.; Melstrom, Kurt; Warner, Susanne G.; Melstrom, Laleh G.; Lai, Lily; Fong, Yuman; Woo, Yanghee

doi:10.1007/s00464-018-6554-9

Cited by 62 publications

(41 citation statements)

References 36 publications

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“…There is a national trend towards increasing the use of the robotic platform for pancreas surgery, including pancreas surgery for malignancy. 5 Within our own data, this finding can in part be explained by the acquisition of new faculty with robotic experience, and increased support by the institution for robotic procedures.…”

Section: Cost Comparisonmentioning

confidence: 79%

Minimally invasive distal pancreatectomy and the cost of conversion

Stewart

Wong

Selby

et al. 2020

Journal of Surgical Oncology

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Background Minimally invasive surgery (MIS) is preferred for distal pancreatectomy but is not always attempted due to the risk of conversion to open. We hypothesized that the total cost for MIS converted to open procedures would be comparable to those that started open. Methods A prospectively collected institutional registry (2011‐2017) was reviewed for demographic, clinical, and perioperative cost data for patients undergoing distal pancreatectomy. Results There were 80 patients who underwent distal pancreatectomy: 41 open, 39 MIS (11 laparoscopic and 28 robotic). Conversion to open occurred in 14 of 39 (36%, 3 laparoscopic and 11 robotic). Length of stay was shorter for the MIS completed (6 days; range, 3‐8), and MIS converted to open (7 days; range, 4‐10) groups, compared with open (10 days; range, 5‐36; P = .003). Laparoscopic cases were the least expensive (P = .02). Robotic converted to open procedures had the highest operating room cost. However, the total cost for robotic converted to open cohort was similar to the open cohort due to cost savings associated with a shorter length of stay. Conclusions Despite the higher intraoperative costs of robotic surgery, there is no significant overall financial penalty for conversion to open. Financial considerations should not play a role in selecting a robotic or open approach.

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Section: Cost Comparisonmentioning

confidence: 79%

Minimally invasive distal pancreatectomy and the cost of conversion

Stewart

Wong

Selby

et al. 2020

Journal of Surgical Oncology

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“…This is consistent with overall sales 32 and other studies showing that use continues to grow despite the lack definitive improved outcomes. 33,34 So what is driving this landslide of robotic usage? From the beginning robotic surgery has excited the surgical field, 35 and with ever expanding indications and technologies it is natural for surgeons to desire to keep up with the latest.…”

Section: Discussionmentioning

confidence: 99%

Sigmoidectomy for Diverticulitis—A Propensity-Matched Comparison of Minimally Invasive Approaches

Ogilvie

Saunders

Parker

et al. 2019

Journal of Surgical Research

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a b s t r a c tBackground: As the availability and use of robotic surgery increases, current data suggest comparable outcomes to laparoscopic surgery but at an increased cost. Elective sigmoid resection for diverticular disease is the most common colorectal application of robotic surgery and there is limited comparative data specifically for this indication. Methods:We identified all elective cases of laparoscopic-and robot-assisted surgery for diverticular disease among a practice of 7 colorectal surgeons within an established enhanced recovery protocol. We performed propensity matching based on surgical indications (recurrent disease, ongoing symptoms, or fistula), stoma creation, and body mass index to create a matched cohort. Our primary outcomes were return of bowel function, length of stay, opioid use, and pain scores during the first 72 h postoperatively. Secondary outcomes were operative room and hospital charges.Results: From 2011 to 2016, 69 robotic cases were propensity matched from a group of 222 laparoscopic cases to create a 1:1 case ratio that was equivalent in terms of patient demographics and operative indications. Time to first bowel movement was slightly quicker in the robotic group (1 [1] versus 2 [1.5], P ¼ 0.09), while length of stay (3.5 [1.6] versus 3.6 [1.4] d, P ¼ 0.64) was equivalent. Pain scores were lower in the robotic group on day 0 (4.6 versus 6.1, P ¼ 0.0001), but similar on day 1 and day 2 (4.3 versus 4.1, P ¼ 0.62 and 3.8 versus 3.3, P ¼ 0.19). There was no difference in postoperative 72-h opioid use between groups (110.8 MME [144.5] versus 97.4 MME [101.5], P ¼ 0.70). In the robotic arm operating room charges were slightly more ($2835 AE $394 versus $2196 AE $359, P < 0.0001), but total hospital charges were over significantly increased ($41,159 [$7840] versus $25,761 [$11,689], P < 0.0001).Conclusions: Via a carefully matched cohort of elective sigmoid resection for diverticular disease at a single community institution, we have demonstrated that laparoscopic-and robotic-assisted surgery result in clinically equivalent return of bowel function, length of stay, postoperative pain, and opioid use. ª

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“…Robot‐assisted operations accounted for 3% of all general surgical oncology cases between 2010 and 2014 in the United States . Five percent of all liver surgeries were performed robotically, with robot‐assisted surgeries an increasingly larger share of these cases.…”

Section: Robot‐assisted Liver Resectionmentioning

confidence: 99%

“…Robot-assisted operations accounted for 3% of all general surgical oncology cases between 2010 and 2014 in the United States. 22 Five percent of all liver surgeries were performed robotically, with robotassisted surgeries an increasingly larger share of these cases. The consensus opinion during the second international laparoscopic liver 23 The authors concluded that robotic hepatectomy was safe and effective, noting shorter median operating times, lower estimated operative blood loss, and shorter hospital stays for patients undergoing robotic resection.…”

Section: Robot-assisted Liver Resectionmentioning

confidence: 99%

Treatment of metastatic colorectal cancer: innovations in surgical techniques

Andrade

Warner

Fong

2019

Journal of Surgical Oncology

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Liver metastases and peritoneal carcinomatosis are a particular focus of surgeons in improving survival in stage IV colorectal cancer patients, with laparotomy long being the means to undertake these operations. The Louisville statement published in 2008 was the first international consensus on indications for minimally invasive liver resection. Herein we review the progress in innovative surgical techniques, including minimally invasive liver resection, robot‐assisted hepatectomy, and we also describe initial reports in pressurized intraperitoneal aerosol chemotherapy.

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Robotic surgery trends in general surgical oncology from the National Inpatient Sample

Cited by 62 publications

References 36 publications

Minimally invasive distal pancreatectomy and the cost of conversion

Minimally invasive distal pancreatectomy and the cost of conversion

Sigmoidectomy for Diverticulitis—A Propensity-Matched Comparison of Minimally Invasive Approaches

Treatment of metastatic colorectal cancer: innovations in surgical techniques

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