Chicago 2009 Video – Costs of robotic nephrectomy: comparison with open surgery
November 28, 2009
L. Giulianotti
Background/Hypothesis
Robotic surgery is an emerging technology with great potential but unknown cost-effectiveness. Aim of this study is to compare the Intra-hospital cost of Robotics with open surgery for living donor nephrectomy.
Materials & Methods
Two groups of patients were analyzed. Group 1 consisted of 39 consecutive patients who underwent open living donor nephrectomy (OLDN) performed at UIC from January 1997 to December 1999 and Group 2 of 165 consecutive who underwent robotic hand-assisted donor nephrectomy (RHADN) from January 2004 to June 2006. The time frames were selected to eliminate the learning curve for both the procedures. The authors reviewed clinical charts with regards to OR time, intra operative blood loss (EBL) and blood transfusion rate, ICU admission rate, length of post-operative stay (LOS) and complications. To decrease the bias in both groups all costs related to surgery, such as instruments and medical devices, were updated to present time. Chi-square, Mann-Whitney and t-tests were used for statistical evaluations. All analyses were completed using SAS v.9.1.3.
Results
The overall intra-hospital cost of RHADN ($ 11,064.60) was comparable to Open Surgery ($ 11,398.40)
Conclusions
RHADN has the same economical cost for the intraoperative stay as open nephrectomy. The higher cost of technology is counterbalanced by shorter operative times and decreased length of stay. The middle to long term benefits of minimally-invasive surgery, not evaluated in the present study, could continue to shift the economical balance in favor of robotic surgery.
