Outcomes and Costs Associated With Robotic Colectomy in the Minimally Invasive Era

Abstract

Robotic-assisted colectomy significantly increases the costs of care without providing clear reductions in overall morbidity or length of stay. As the use of robotic technology in colon surgery continues to evolve, critical appraisal of the benefits offered in comparison with the resources consumed is required.

A comparison of laparoscopic and robotic colorectal surgery outcomes using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database

“…These authors attributed these results to less ileus in the robotic group. Decreased ileus in favor of robotic operations was also demonstrated by another database analysis [14]. A large protocol-driven regional database analysis also demonstrated a significantly shorter LOS for the robotic approach when compared to LC for colectomies (p = 0.008) [49].…”

The biological complexity of colorectal cancer: insights into biomarkers for early detection and personalized care

“…Several international multicenter randomized trials have shown that minimally invasive surgery is a safe and valid alternative to open surgery, with less postoperative pain, shorter duration of hospital stay, and similar oncological outcomes. Robotic surgery has not been shown to be better for either colon or rectal cancer, compared with an adequate laparoscopic approach [Tyler et al 2013;Baek et al 2013].…”

The robotic colorectal surgeon

“…This does however; demonstrate that robotic surgery appears to be safe in the right hands. Larger population based studies also support the observation that robotic and laparoscopic approaches have similar complication rates; in a review of the 2008-2009 inpatient sample, robotic surgery was observed to have a 3.0% intra-operative complication rate compared to 3.3% for laparoscopy 32 . Post-operative complication rates were observed to be 21.7% and 21.6% for robotic and laparoscopic surgeries, respectively.…”

“…Little medical literature exists directly addressing the costs of laparoscopic versus robotic colorectal surgery; a single analysis from Korea documents a difference in cost of $15,000 for robotic surgery versus $10,000 for laparoscopic surgery for total hospital charges in US dollars 31 . A review of the nationwide inpatient sample from 2008 to 2009 found that for colorectal surgery in the United States, use of a robotic surgical system increased costs from $15,800 to $19,231 compared to laparoscopic surgery 32 . The same review reported no difference in overall complication rates and length of stay.…”