Robotic Versus Open Renal Transplantation in Obese Patients: Protocol for a Cost-Benefit Markov Model Analysis (Preprint)

Abstract

A Markov model will be developed to simulate a randomized controlled study to assess the costeffectiveness of robotic-assisted renal transplantation in comparison to open surgery in obese patients. Project SummaryThe number of patients affected by renal insufficiency and obesity is growing, especially in North America where obesity has reached epidemic proportions. Obesity is associated with several comorbidities that increase the risks of wound complications. Wound infections are one of the most common nosocomial complications in patients who undergo contaminated surgical procedures or who are immunosuppressed or diabetic. Often, obese patients who undergo renal transplantation have diabetes in addition to being immunosuppressed and develop some degree of wound complications (infections, seromas, dehiscence, hernias) in up to 50% of cases. Wound complications represent a significant clinical and economic burden to the health-care system. In particular, wound infections are responsible for longer hospitalizations and decreased functional capacity of renal transplant recipients who require extramural nursing for the management of their wound-vacuum devices and local debridement and packing of their incisions.