A Comparative Direct Cost Analysis of Pediatric Urologic Robot-Assisted Laparoscopic Surgery Versus Open Surgery: Could Robot-Assisted Surgery Be Less Expensive?

2012 ◽  
Vol 26 (7) ◽  
pp. 871-877 ◽  
Author(s):  
Courtney K. Rowe ◽  
Michael W. Pierce ◽  
Katherine C. Tecci ◽  
Constance S. Houck ◽  
James Mandell ◽  
...  
2010 ◽  
Vol 31 (8) ◽  
pp. 822-827 ◽  
Author(s):  
Elizabeth D. Hermsen ◽  
Tim Hinze ◽  
Harlan Sayles ◽  
Lee Sholtz ◽  
Mark E. Rupp

Objective.Robot-assisted surgery is minimally invasive and associated with less blood loss and shorter recovery time than open surgery. We aimed to determine the duration of robot-assisted surgical procedures and the incidence of postoperative surgical site infection (SSI) and to compare our data with the SSI incidence for open procedures according to national data.Design.Retrospective cohort study.Setting.A 689-bed academic medical center.Patients.All patients who underwent a surgical procedure with use of a robotic surgical system during the period from 2000-2007.Methods.SSIs were defined and procedure types were classified according to National Healthcare Safety Network criteria. National data for comparison were from 1992-2004. Because of small sample size, procedures were grouped according to surgical site or wound classification.Results.Sixteen SSIs developed after 273 robot-assisted procedures (5.9%). The mean surgical duration was 333.6 minutes. Patients who developed SSI had longer mean surgical duration than did patients who did not (558 vs 318 minutes; P<.001). The prostate and genitourinary group had 5.74 SSIs per 100 robot-assisted procedures (95% confidence interval [CI], 2.81–11.37), compared with 0.85 SSIs per 100 open procedures from national data. The gynecologic group had 10.00 SSIs per 100 procedures (95% CI, 2.79–30.10), compared with 1.72 SSIs per 100 open procedures. The colon and herniorrhaphy groups had 33.33 SSIs per 100 procedures (95% CI, 9.68–70.00) and 37.50 SSIs per 100 procedures (95% CI, 13.68–69.43), respectively, compared with 5.88 and 1.62 SSIs per 100 open procedures from national data. Patients with a clean-contaminated wound developed 6.1 SSIs per 100 procedures (95% CI, 3.5–10.3), compared with 2.59 SSIs per 100 open procedures. No significant differences in SSI rates were found for other groups.Conclusions.Increased incidence of SSI after some types of robot-assisted surgery compared with traditional open surgery may be related to the learning curve associated with use of the robot.


2020 ◽  
Vol 7 (2) ◽  
pp. 74-78
Author(s):  
Baki Ekci ◽  
Gokhan Agturk

The use of tools and machines in the field of medicine is very old, although the use of robots datesback to several decades. The purpose of using machinery and robots in the industry is to reduceproduction costs in the industry. Unlike machines, robots are energy-driven mechanical systemsdesigned to perform learned operations and movements in a much safer faster and more economicalway. In the medical sector, robots used outside operations are used to automate certain tasks. Butthe surgical robots are controlled by the surgeons and used to facilitate the surgeons' work. In otherwords, they do not move except for the surgeon’s control and do not perform an automated procedureand they do not have artificial intelligence now. In this context, it is more appropriate to use the termrobotic-assisted surgical equipment, robot-assisted minimally invasive surgery or roboticallyassisted surgical devices rather than using the word “robot”. In short, robots used in surgeries aremachines designed to perform more complex, thinner, more precise tasks. In this review, we will beevaluating the robot, the different medical assistants and robotic surgery, the da Vinci robot, and thedifferences between the open surgery, laparoscopic surgery, and robot-assisted surgery.


2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Peter van Dam ◽  
Jan Hauspy ◽  
Luc Verkinderen ◽  
Xuan Bich Trinh ◽  
Pieter-Jan van Dam ◽  
...  

The exponential use of robotic surgery is not the result of evidence-based benefits but mainly driven by the manufacturers, patients and enthusiastic surgeons. The present review of the literature shows that robot-assisted surgery is consistently more expensive than video-laparoscopy and in many cases open surgery. The average additional variable cost for gynecological procedures was about 1600 USD, rising to more than 3000 USD when the amortized cost of the robot itself was included. Generally most robotic and laparoscopic procedures have less short-term morbidity, blood loss, intensive care unit, and hospital stay than open surgery. Up to now no major consistent differences have been found between robot-assisted and classic video-assisted procedures for these factors. No comparative data are available on long-term morbidity and oncologic outcome after open, robotic, and laparoscopic gynecologic surgery. It seems that currently only for very complex surgical procedures, such as cardiac surgery, the costs of robotics can be competitive to open surgical procedures. In order to stay viable, robotic programs will need to pay for themselves on a per case basis and the costs of robotic surgery will have to be reduced.


2016 ◽  
Vol 30 (11) ◽  
pp. 5044-5051 ◽  
Author(s):  
Giorgia Tedesco ◽  
Francesco C. Faggiano ◽  
Erica Leo ◽  
Pietro Derrico ◽  
Matteo Ritrovato

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pedja Cuk ◽  
Andreas Kristian Pedersen ◽  
Kate Lykke Lambertsen ◽  
Christian Backer Mogensen ◽  
Michael Festersen Nielsen ◽  
...  

Abstract Background Robot-assisted surgery is being increasingly adopted in treating colorectal cancer, and the transition from laparoscopic surgery to robot-assisted surgery is a trend. The evidence of the benefits of robot-assisted surgery is sparse. However, findings are associated with improved patient-related outcomes and overall morbidity rates compared to laparoscopic surgery. This induction is unclear, considering both surgical modalities are characterized as minimally invasive. This study aims to evaluate the systemic and peritoneal inflammatory stress response induced by robot-assisted surgery compared with laparoscopic surgery for elective colon cancer resections in a prospective, randomized controlled clinical trial. Methods This study is a single-centre randomized controlled superiority trial with 50 colon cancer participants. The primary endpoint is the level of systemic inflammatory response expressed as serum C-reactive protein (CRP) and interleukin 6 (IL-6) levels between postoperative days one and three. Secondary endpoints include (i) levels of systemic inflammation in serum expressed by a panel of inflammatory and pro-inflammatory cytokines measured during the first three postoperative days, (ii) postoperative surgical and medical complications (30 days) according to Clavien-Dindo classification and Comprehensive Complication Index, (iii) intraoperative blood loss, (iv) conversion rate to open surgery, (v) length of surgery, (vi) operative time, (vii) the number of harvested lymph nodes, and (viii) length of hospital stay. The exploratory endpoints are (i) levels of peritoneal inflammatory response in peritoneal fluid expressed by inflammatory and pro-inflammatory cytokines between postoperative day one and three, (ii) patient-reported health-related quality of recovery-15 (QoR-15), (iii) 30 days mortality rate, (iv) heart rate variability and (v) gene transcript (mRNA) analysis. Discussion To our knowledge, this is the first clinical randomized controlled trial to clarify the inflammatory stress response induced by robot-assisted or laparoscopic surgery for colon cancer resections. Trial registration This trial is registered at Clinicaltrials.gov (Identifier: NCT04687384) on December, 29, 2020, Regional committee on health research ethics, Region of Southern Denmark (N75709) and Data Protection Agency, Hospital Sønderjylland, University Hospital of Southern Denmark (N20/46179).


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