Opportunity cost in the economic evaluation of da Vinci robotic assisted surgery

2015 ◽  
Vol 17 (3) ◽  
pp. 245-256 ◽  
Author(s):  
Fernando Fuertes-Guiró ◽  
Montserrat Girabent-Farrés ◽  
Eduardo Viteri-Velasco
Keyword(s):  
Economic Evaluation ◽  
Opportunity Cost ◽  
Da Vinci ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery

scholarly journals Robotic-Assisted Surgery for Benign Urological Conditions

2006 ◽  
Vol 6 ◽  
pp. 2573-2580 ◽  
Author(s):  
Declan G. Murphy ◽  
Ben J. Challacombe ◽  
Lail-U-Mah Zaheer ◽  
M. Shamim Khan ◽  
Prokar Dasgupta
Keyword(s):  
Radical Prostatectomy ◽  
Da Vinci ◽  
Robotic Assistance ◽  
Robotic Technology ◽  
Robotic Assisted ◽  
The Past ◽  
Robotic Assisted Surgery ◽  
Urological Procedures ◽  
Robotic Assisted Radical Prostatectomy ◽  
Surgical System

Robotic technology for use in surgery has advanced considerably in the past 10 years. This has become particularly apparent in urology where robotic-assisted radical prostatectomy using the da VinciTMsurgical system (Intuitive Surgical, CA) has become very popular. The use of robotic assistance for benign urological procedures is less well documented. This article considers the current robotic technology and reviews the situation with regard to robotic surgery for benign urological conditions.

PP184 Twenty Years of Health Technology Assessments on Robotic Assisted Surgery: A Summary

2021 ◽  
Vol 37 (S1) ◽  
pp. 25-25
Author(s):  
Ben Forrest ◽  
Nikhil Sahai ◽  
Chao Song
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Literature Search ◽  
Da Vinci ◽  
Health Technology ◽  
Surgical Indication ◽  
Annual Number ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery ◽  
Nose And Throat

IntroductionDa Vinci robotic-assisted surgery (RAS) has been evaluated by health technology assessment (HTA) organizations across the world. This study aimed to analyze the existing HTA reports over years, countries, and procedures.MethodsPublicly available health technology appraisal reports on RAS published from January 2000 to November 2020 were identified via a targeted literature search. The literature search was conducted in PubMed, the Centre for Reviews and Dissemination database, the International Network of Agencies for Health Technology Assessment database, and Google scholar. Reports related to the da Vinci RAS were included. Full texts of reports were used for the analysis.For the HTAs that recommended RAS, the directional conclusion was considered as positive. For HTA reports that discouraged the use of RAS, the directional conclusion was considered as negative. The rest were considered as neutral. The reports were analyzed by year, country, and procedure.ResultsWe identified 65 HTA reports comprising 128 procedure-level assessments of RAS by 42 HTA organizations in 21 countries over 20 years. The annual number of assessments increased over time. The countries that completed the most assessments were Sweden (14 reports, including 15 procedure-level assessments: 13% positive and 80% neutral) and Canada (11 reports, including 20 procedure-level assessments: 65% positive).The topics of the assessments covered 27 surgical indications in urology, gynecology, thoracic, general, and ear, nose, and throat. The conclusions of the HTAs varied by surgical indication. Prostatectomy (33 reports: 85% neutral or positive) was the most widely assessed surgical indication, followed by hysterectomy (16 reports: 81% neutral or positive), nephrectomy (15 reports: 73% neutral or positive), and rectal resection (10 reports: 100% neutral or positive).ConclusionsThe number and breadth of HTAs on RAS have grown at an increasing rate over the last 20 years. The directional conclusion of assessments varied by procedure and country. Further analysis is warranted to understand the factors contributing to HTA conclusions on RAS.

Robotic-Assisted Ivor Lewis Esophagectomy (RAMIE) with a Standardized Intrathoracic Circular End-to-side Stapled Anastomosis and a Team of Two (Surgeon and Assistant Only)

2017 ◽  
Vol 66 (05) ◽  
pp. 404-406 ◽  
Author(s):  
Edin Hadzijusufovic ◽  
Hauke Lang ◽  
Peter Grimminger
Keyword(s):  
Da Vinci ◽  
Minimal Invasive ◽  
Operation Technique ◽  
Da Vinci Xi ◽  
Ivor Lewis ◽  
Robotic Assisted ◽  
Invasive Esophagectomy ◽  
Ivor Lewis Esophagectomy ◽  
The Past ◽  
Robotic Assisted Surgery

AbstractRobotic-assisted surgery is rapidly increasing, especially in general surgery. It has been shown for years that the minimal invasive esophagectomy (MIE) is possible using a robotic system, for example, da Vinci Xi, Intuitive Surgical. In the past, most robotic esophageal resections have been performed thoracoscopically, and the anastomosis was mostly sutured at the neck. Due to the increase of usable instruments and technical progress, it is possible to perform the total abdominothoracic esophagectomy with an intrathoracic sutured anastomosis robotically. In this article, we would like to present the standardized operation technique and tricks for the robotic-assisted (da Vinci Xi) Ivor Lewis MIE (RAMIE), especially the robotic technique in combination with a standardized intrathoracic circular end-to-side stapled esophagogastric anastomosis.

scholarly journals Nintendo Da Vinci: Implementing a novel control system to improve performance in robotic assisted surgery – A pilot study

2019 ◽  
Author(s):  
Ibrahim S Al-Akash
Keyword(s):  
Control System ◽  
Da Vinci ◽  
Learning Rate ◽  
Skills Assessment ◽  
Improve Performance ◽  
Surgical Performance ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery ◽  
Proper Training ◽  
Task Time

Complications of robotic-assisted surgery are on the rise, partly due to surgeons not receiving proper training. Using the current Da Vinci (DV) surgical system, 150-3,000 surgeries must be performed to achieve proficiency. To improve performance, a new system was developed using Nintendo Joycon (NJ) controls. The system was tested using NJ and the DV control systems, with two users (gamer and doctor), in a simulated skills assessment in 2-dimensional (2D) and 3-dimensional (3D) modes. The simulation completion time and error count were used to calculate a Fundamentals of Robotic Surgery Skills Assessment (FRS) score. The results indicate the task time, error, FRS scores, and learning rates had improved significantly (p<0.05). The risk ratios indicate the Da Vinci control system increases the risk of error significantly (p<0.05). Based on the data collected in this study, implementing a Nintendo Joycon control system improves task time by 83% for the doctor and by 88% for the gamer, reduces error by 73% for the doctor and by 82% for the gamer, improves FRS score by 72% for the doctor and by 46% for the gamer, and accelerates the learning rate by 84% for the doctor and by 86% for the gamer. The data collected indicates that implementing a Nintendo Joycon control system will significantly improve surgical performance by accelerating the learning rate and reducing error.

scholarly journals Nintendo Da Vinci: Implementing a novel control system to improve performance in robotic assisted surgery – A pilot study

2019 ◽  
Author(s):  
Ibrahim S Al-Akash
Keyword(s):  
Control System ◽  
Da Vinci ◽  
Learning Rate ◽  
Skills Assessment ◽  
Improve Performance ◽  
Surgical Performance ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery ◽  
Proper Training ◽  
Task Time

Complications of robotic-assisted surgery are on the rise, partly due to surgeons not receiving proper training. Using the current Da Vinci (DV) surgical system, 150-3,000 surgeries must be performed to achieve proficiency. To improve performance, a new system was developed using Nintendo Joycon (NJ) controls. The system was tested using NJ and the DV control systems, with two users (gamer and doctor), in a simulated skills assessment in 2-dimensional (2D) and 3-dimensional (3D) modes. The simulation completion time and error count were used to calculate a Fundamentals of Robotic Surgery Skills Assessment (FRS) score. The results indicate the task time, error, FRS scores, and learning rates had improved significantly (p<0.05). The risk ratios indicate the Da Vinci control system increases the risk of error significantly (p<0.05). Based on the data collected in this study, implementing a Nintendo Joycon control system improves task time by 83% for the doctor and by 88% for the gamer, reduces error by 73% for the doctor and by 82% for the gamer, improves FRS score by 72% for the doctor and by 46% for the gamer, and accelerates the learning rate by 84% for the doctor and by 86% for the gamer. The data collected indicates that implementing a Nintendo Joycon control system will significantly improve surgical performance by accelerating the learning rate and reducing error.

scholarly journals Detailed cost of robotic-assisted surgery in the Australian public health sector: from implementation to a multi-specialty caseload

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kate McBride ◽  
Daniel Steffens ◽  
Christina Stanislaus ◽  
Michael Solomon ◽  
Teresa Anderson ◽  
...  
Keyword(s):  
Public Sector ◽  
Health Sector ◽  
Public Hospitals ◽  
Fixed Costs ◽  
Tertiary Referral Hospital ◽  
Robotic Assisted ◽  
The Public ◽  
Robotic Assisted Surgery ◽  
Specific Implementation ◽  
Theatre Utilisation

Abstract Background A barrier to the uptake of robotic-assisted surgery (RAS) continues to be the perceived high costs. A lack of detailed costing information has made it difficult for public hospitals in particular to determine whether use of the technology is justified. This study aims to provide a detailed description of the patient episode costs and the contribution of RAS specific costs for multiple specialties in the public sector. Methods A retrospective descriptive costing review of all RAS cases undertaken at a large public tertiary referral hospital in Sydney, Australia from August 2016 to December 2018 was completed. This included RAS cases within benign gynaecology, cardiothoracic, colorectal and urology, with the total costs described utilizing various inpatient costing data, and RAS specific implementation, maintenance and consumable costs. Results Of 211 RAS patients, substantial variation was found between specialties with the overall median cost per patient being $19,269 (Interquartile range (IQR): $15,445 to $32,199). The RAS specific costs were $8828 (46%) made up of fixed costs including $4691 (24%) implementation and $2290 (12%) maintenance, both of which are volume dependent; and $1848 (10%) RAS consumable costs. This was in the context of 37% robotic theatre utilisation. Conclusions There is considerable variation across surgical specialties for the cost of RAS. It is important to highlight the different cost components and drivers associated with a RAS program including its dependence on volume and how it fits within funding systems in the public sector.

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