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Ahmadi N, Mor I, Warner R. Comparison of outcome and costs of robotic and laparoscopic right hemicolectomies. J Robot Surg. 2021;doi: 10.1007/s11701-021-01246-z.
Ahmadi, N., Mor, I., & Warner, R. (2021). Comparison of outcome and costs of robotic and laparoscopic right hemicolectomies. Journal of robotic surgery, . https://doi.org/10.1007/s11701-021-01246-z
Ahmadi, Nima, et al. "Comparison of outcome and costs of robotic and laparoscopic right hemicolectomies." Journal of robotic surgery vol. (2021). doi: https://doi.org/10.1007/s11701-021-01246-z
Ahmadi N, Mor I, Warner R. Comparison of outcome and costs of robotic and laparoscopic right hemicolectomies. J Robot Surg. 2021 Jun 03; doi: 10.1007/s11701-021-01246-z. Epub 2021 Jun 03. PMID: 34081291.
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J Robot Surg. 2021 Jun 03; doi: 10.1007/s11701-021-01246-z. Epub 2021 Jun 03.

Comparison of outcome and costs of robotic and laparoscopic right hemicolectomies.

Journal of robotic surgery

Nima Ahmadi, Isabella Mor, Ross Warner

Affiliations

  1. Department of Colorectal Surgery, The Tweed Hospital, Powell St, Tweed Heads, NSW, 2485, Australia.
  2. Department of Colorectal Surgery, John Flynn Private Hospital, Tugun, QLD, 4224, Australia.
  3. Department of Colorectal Surgery, The Tweed Hospital, Powell St, Tweed Heads, NSW, 2485, Australia. [email protected].
  4. Department of Colorectal Surgery, John Flynn Private Hospital, Tugun, QLD, 4224, Australia. [email protected].

PMID: 34081291 DOI: 10.1007/s11701-021-01246-z

Abstract

To compare the outcomes of patients undergoing right hemicolectomy using laparoscopic or robotic approaches and perform a cost analysis. Retrospective review of all patients undergoing elective laparoscopic and robotic right hemicolectomies at a public and private hospital in NSW/QLD from January 2015 to June 2018. Cost analysis was calculated using actual and estimated costs by the local health district. A total of 101 patients were identified. 59 (58%) had Robotic resection, of which 44 (75%) had an intra-corporeal anastomosis. There were no demographic or oncological differences between the two groups. The robotic group had a significantly earlier time to bowels opening (2 vs 4 days, p < 0.001) and shorter length of stay (3 vs 5 days, p < 0.001). The robotic group had a lower rate of ileus (2% vs 14%, p = 0.02) and complications (5% vs 33%, p = 0.006). The mean lymph node harvest was higher in the robotic group (18 vs 14, p = 0.001). The operative time was longer in the robotic group (110 vs 97 min, p = 0.021). The total instrument costs of robotic surgery were A$2565.37 compared with $1507.50 for laparoscopic surgery. The cost of bed days was A$1167.00/day. The average difference in cost of care was calculated as A$1276.13 and A$464.43 less in the robotic with intra-corporeal and extra-corporeal anastomosis, respectively. Patients have significantly faster return to bowel function and shorter length of stay after Robotic vs laparoscopic right hemicolectomy and experience fewer complications. This difference in length of stay may make robotic right hemicolectomies more cost effective.

Keywords: Colectomy; Costs and cost analysis; Laparoscopy; Patient outcome assessment; Robotic surgical procedures

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