Cost-effectiveness of robotic-assisted surgery vs open surgery in the context of partial nephrectomy for small kidney tumors

Baghli, Adnan; Achit, Hamza; Audigé, Victor; Larré, S.; Branchu, Benjamin; Balkau, Beverley; Eschwège, P.; Hubert, Jacques; Mazeaud, Charles

doi:10.1007/s11701-023-01552-8

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…Accordingly, Bahler et al highlighted in their work at a longitudinal approach that robotic surgery was still USD 1464 more expensive than open surgery in 2009, though already USD 456 cheaper in 2012 [ 5 ]; the same was confirmed by Camp et al for the United Kingdom [ 29 ]. In this regard, robotic surgery has become more cost-effective in recent years [ 10 ]. A direct comparison of these analyses with our data is difficult since healthcare systems widely differ and the cost factors analyzed here were often ignored in the above-mentioned works.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, a profitable use appears to be possible [ 6 , 7 ]. Some studies even indicate cost savings in high-volume centers compared to open surgery [ 5 , 8 , 9 , 10 ]. Of great importance, lower morbidity, with at least equivalent oncologic outcomes compared with the open approach, has been proven for almost all robot-assisted interventions [ 11 , 12 , 13 , 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Last Resort from Nursing Shortage? Comparative Cost Analysis of Open vs. Robot-Assisted Partial Nephrectomies with a Focus on the Costs of Nursing Care

Zeuschner

Böttcher

Hager

et al. 2023

Cancers

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Despite perioperative advantages, robot-assisted surgery is associated with high costs. However, the lower morbidity of robotic surgery could lead to a lower nursing workload and cost savings. In this comparative cost analysis of open retroperitoneal versus robot-assisted transperitoneal partial nephrectomies (PN), these possible cost savings, including other cost factors, were quantified. Therefore, patient, tumor characteristics, and surgical results of all PN within two years at a tertiary referral center were retrospectively analyzed. The nursing effort was quantified by the local nursing staff regulation and INPULS® intensive care and performance-recording system. Out of 259 procedures, 76.4% were performed robotically. After propensity score matching, the median total nursing time (2407.8 vs. 1126.8 min, p < 0.001) and daily nursing effort (245.7 vs. 222.6 min, p = 0.025) were significantly lower after robotic surgery. This resulted in mean savings of EUR 186.48 in nursing costs per robotic case, in addition to savings of EUR 61.76 due to less frequent administrations of erythrocyte concentrates. These savings did not amortize the higher material costs for the robotic system, causing additional expenses of EUR 1311.98 per case. To conclude, the nursing effort after a robotic partial nephrectomy was significantly lower compared to open surgery; however, this previously unnoticed savings mechanism alone could not amortize the overall increased costs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Last Resort from Nursing Shortage? Comparative Cost Analysis of Open vs. Robot-Assisted Partial Nephrectomies with a Focus on the Costs of Nursing Care

Zeuschner

Böttcher

Hager

et al. 2023

Cancers

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“…2 Roboticassisted surgery is more costly upfront than the laparoscopic or open alternative, although the decrease in complication rate and shorter length of hospital stay is thought to offset the higher cost at least partially. 4,5 As of the third quarter of 2022, there were 7364 da Vinci surgical systems installed worldwide, an increase of 13% from 1-year prior. 6 Procedures grew by approximately 20% in the same year, resulting in a quarterly revenue of $1.56 billion.…”

Section: Introductionmentioning

confidence: 99%

New multiport robotic surgical systems: a comprehensive literature review of clinical outcomes in urology

Salkowski,

Checcucci,

Chow

et al. 2023

Therapeutic Advances in Urology

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Over the past 20 years, the field of robotic surgery has largely been dominated by the da Vinci robotic platform. Nevertheless, numerous novel multiport robotic surgical systems have been developed over the past decade, and some have recently been introduced into clinical practice. This nonsystematic review aims to describe novel surgical robotic systems, their individual designs, and their reported uses and clinical outcomes within the field of urologic surgery. Specifically, we performed a comprehensive review of the literature regarding the use of the Senhance robotic system, the CMR-Versius robotic system, and the Hugo RAS in urologic procedures. Systems with fewer published uses are also described, including the Avatera, Hintori, and Dexter. Notable features of each system are compared, with a particular emphasis on factors differentiating each system from the da Vinci robotic system.

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A systematic review of full economic evaluations of robotic-assisted surgery in thoracic and abdominopelvic procedures

Sadri,

Fung-Kee-Fung,

Shayegan

et al. 2023

J Robotic Surg

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This study aims to conduct a systematic review of full economic analyses of robotic-assisted surgery (RAS) in adults' thoracic and abdominopelvic indications. Authors used Medline, EMBASE, and PubMed to conduct a systematic review following the preferred reporting items for systematic reviews and meta‐analyses (PRISMA) 2020 guidelines. Fully published economic articles in English were included. Methodology and reporting quality were assessed using standardized tools. Majority of studies (28/33) were on oncology procedures. Radical prostatectomy was the most reported procedure (16/33). Twenty-eight studies used quality-adjusted life years, and five used complication rates as outcomes. Nine used primary and 24 studies used secondary data. All studies used modeling. In 81% of studies (27/33), RAS was cost-effective or potentially cost-effective compared to comparator procedures, including radical prostatectomy, nephrectomy, and cystectomy. Societal perspective, longer-term time-horizon, and larger volumes favored RAS. Cost-drivers were length of stay and equipment cost. From societal and payer perspectives, robotic-assisted surgery is a cost-effective strategy for thoracic and abdominopelvic procedures.Clinical trial registration This study is a systematic review with no intervention, not a clinical trial.

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Cost-effectiveness of robotic-assisted surgery vs open surgery in the context of partial nephrectomy for small kidney tumors

Cited by 4 publications

References 15 publications

Last Resort from Nursing Shortage? Comparative Cost Analysis of Open vs. Robot-Assisted Partial Nephrectomies with a Focus on the Costs of Nursing Care

Last Resort from Nursing Shortage? Comparative Cost Analysis of Open vs. Robot-Assisted Partial Nephrectomies with a Focus on the Costs of Nursing Care

New multiport robotic surgical systems: a comprehensive literature review of clinical outcomes in urology

A systematic review of full economic evaluations of robotic-assisted surgery in thoracic and abdominopelvic procedures

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