• Benedetto Ielpo, H Duran, E Diaz, I Fabra, R Caruso, L Malavé, V Ferri, J Nuñez, A Ruiz-Ocaña, E Jorge, S Lazzaro, D Kalivaci, Y Quijano, and E Vicente.
• General Surgery Department, Sanchinarro Hospital HM, CEU San Pablo University of Madrid, Madrid, Spain. ielpo.b@gmail.com.
• Int J Colorectal Dis. 2017 Oct 1; 32 (10): 1423-1429.

PurposeThe costs involved in performing robotic surgery present a critical issue which has not been well addressed yet. The aims of this study are to compare the clinical outcomes and cost differences of robotic versus laparoscopic surgery in the treatment of rectal cancer and to conduct a literature review of the cost analysis.MethodsThis is an observational, comparative study whereby data were abstracted from a retrospective database of patients who underwent laparoscopic and robotic rectal resection from October 2010 to March 2017, at Sanchinarro University Hospital, Madrid. An independent company performed the financial analysis, and fixed costs were excluded.ResultsA total of 86 robotic and 112 laparoscopic rectal resections were included. The mean operative time was significantly lower in the laparoscopic approach (336 versus 283 min; p = 0.001). The main pre-operative data, overall morbidity, hospital stay and oncological outcomes were similar in both groups, except for the readmission rate (robotic: 5.8%, laparoscopic: 11.6%; p = 0.001). The mean operative costs were higher for robotic surgery (4285.16 versus 3506.11€; p = 0.04); however, the mean overall costs were similar (7279.31€ for robotic and 6879.8€ for the laparoscopic approach; p = 0.44). We found four studies reporting costs, three comparing robotic versus laparoscopy costs, with all of them reporting a higher overall cost for the robotic rectal resection.ConclusionRobotic rectal resection has similar clinical outcomes to that of the conventional laparoscopic approach. Despite the higher operative costs of robotic rectal resection, overall mean costs were similar in our series.

23 keywords...

hide…