The cost of robotics: an analysis of the added costs of robotic-assisted versus laparoscopic surgery using the National Inpatient Sample

Background Robotic-assisted surgery (RAS) with its advantages continues to gain popularity among surgeons. This study analyzed the increased costs of RAS in common surgical procedures using the National Inpatient Sample. Methods Retrospective analysis of the 2012–2014 Healthcare Cost and Utilization...

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Bibliographic Details
Published in:Surgical endoscopy Vol. 33; no. 7; pp. 2217 - 2221
Main Authors: Khorgami, Zhamak, Li, Wei T., Jackson, Theresa N., Howard, C. Anthony, Sclabas, Guido M.
Format: Journal Article
Language:English
Published: New York Springer US 01.07.2019
Springer Nature B.V
Subjects:
Abdominal Surgery
Cholecystectomy
Colorectal surgery
Costs
Costs and Cost Analysis
Databases, Factual
Direct Service Costs
Female
Gastroenterology
Gynecology
Hepatology
Hernias
Humans
Laparoscopy
Laparoscopy - economics
Laparoscopy - statistics & numerical data
Male
Medicine
Medicine & Public Health
Middle Aged
Procedures and Techniques Utilization - economics
Procedures and Techniques Utilization - statistics & numerical data
Proctology
Retrospective Studies
Robotic surgery
Robotic Surgical Procedures - economics
Robotic Surgical Procedures - statistics & numerical data
Surgery
Surgical Procedures, Operative - economics
Surgical Procedures, Operative - methods
Surgical Procedures, Operative - statistics & numerical data
United States
United States
Robotic surgery
Cholecystectomy
Costs
Ventral hernia repair
Colectomy
Hysterectomy
Laparoscopic
ISSN:0930-2794, 1432-2218, 1432-2218
Online Access:Get full text
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Summary:Background Robotic-assisted surgery (RAS) with its advantages continues to gain popularity among surgeons. This study analyzed the increased costs of RAS in common surgical procedures using the National Inpatient Sample. Methods Retrospective analysis of the 2012–2014 Healthcare Cost and Utilization Project-NIS was performed for the following laparoscopic/robotic procedures: cholecystectomy, ventral hernia repair, right and left hemicolectomy, sigmoidectomy, abdominoperineal resection, and total abdominal hysterectomy (TAH). Patients with additional concurrent procedures were excluded. Costs were compared between the laparoscopic procedures and their RAS counterparts. Total costs and charges for cholecystectomy (the most common procedure in the dataset) were compared based on the payer and characteristics of hospital (region, rural/urban, bed size, and ownership). Results A total of 91,630 surgeries (87,965 laparoscopic, 3665 robotic) were analyzed. The average cost for the laparoscopic group was $10,227 ± $4986 versus $12,340 ± $5880 for the robotic cases ( p  < 0.001). The overall and percentage increases for laparoscopic versus robotic for each procedure were as follows: cholecystectomy $9618 versus $10,944 (14%), ventral hernia repair $10,739 versus $13,441 (25%), right colectomy $12,516 versus $15,027 (20%), left colectomy $14,157 versus $17,493 (24%), sigmoidectomy $13,504 versus $16,652 (23%), abdominoperineal resection $17,708 versus $19,605 (11%), and TAH $9368 versus $9923 (6%). Hysterectomy was the only procedure performed primarily using RAS and it was found to have the lowest increase in costs. Increased costs were associated with even higher increases in charges, especially in investor-owned private hospitals. Conclusion RAS is more costly when compared to conventional laparoscopic surgery. Additional costs may be lower in centers that perform a higher volume of RAS. Further analysis of long-term outcomes (including reoperations and readmissions) is needed to better compare the life-long treatment costs for both surgical approaches.
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ISSN:0930-2794
1432-2218
1432-2218
DOI:10.1007/s00464-018-6507-3