Robotic Assisted General Surgery: Really cost prohibitive?

Wanda M Good, DO, Jason Cundiff, MD, Sherri L Finn, Alainna Simpson. Pacific Northwest University of Health Sciences

Introduction: Robotic assisted general surgery procedures have increased annually since 2011.  Although the advanced technical capabilities inherent to the robotic approach provide many surgical advantages, it is still not perceived to be as cost effective as laparoscopic procedures.  Continually improving intraoperative efficiency and streamlined usage of robotic instrumentation may reduce the operative costs associated with robotics.  A direct case-by-case comparison shows that robotic assisted procedures are comparable and/or more cost effective than their laparoscopic counterparts.

Methods: Operative costs for individual robotic assisted procedures performed by two surgeons at a single institution were reviewed during a one year period (June 2014 – June 2015); including single site and multiport cholecystectomy (n=100), inguinal hernia (n=100), uncomplicated ventral hernia (n=100), appendectomy (n=20).  Operative costs for laparoscopic procedures performed by three surgeons at a single institution were reviewed during a three year period (January 2009 –January 2012); single site and multiport cholecystectomy (n=100), inguinal hernia (n=25), uncomplicated ventral hernia (n=50), appendectomy (n=25).  Operative costs were defined as surgical instrumentation specific to either a robotic assisted or laparoscopic approach.

Results:  

Procedure Robotic Laparoscopic
Single Site Cholecystectomy $648 $674
Multi-port Cholecystectomy $484 $550
Uncomplicated Ventral Hernia $1140 $1400
Inguinal Hernia $1130 $1827

Conclusion: The operative costs of select robotic general surgical procedures compared to identical laparoscopic procedures are equivalent and/or more cost effective.  When reviewed on a case-by-case basis, it appears that the enhanced technical capabilities inherent to the robotic approach may reduce the volume of instrumentation utilized in comparison to laparoscopic. 

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