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Related Experiment Videos

Complete daVinci versus laparoscopic pyeloplasty: cost analysis.

Sam B Bhayani1, Richard E Link, John M Varkarakis

  • 1James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, 600 N. Wolfe Street, Jefferson Building 161, Baltimore, MD 21287, USA.

Journal of Endourology
|May 4, 2005
PubMed
Summary

Computer-assisted pyeloplasty (CP) shows promising perioperative results but is more costly than purely laparoscopic pyeloplasty (LP). Laparoscopic pyeloplasty is more cost-effective for treating ureteropelvic junction obstruction.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Health Economics

Background:

  • Ureteropelvic junction (UPJ) obstruction is a common congenital anomaly.
  • Computer-assisted surgery, specifically the daVinci system, is an emerging technique for pyeloplasty.
  • Laparoscopic pyeloplasty is an established minimally invasive approach for UPJ obstruction.

Purpose of the Study:

  • To perform a relative cost analysis of computer-assisted pyeloplasty (CP) versus purely laparoscopic pyeloplasty (LP).
  • To compare the economic viability of these two surgical techniques for UPJ obstruction.

Main Methods:

  • Eight patients underwent computer-assisted pyeloplasty (CP) and 13 underwent purely laparoscopic pyeloplasty (LP).
  • Patients were matched for age, sex, and BMI, all with primary UPJ obstruction.

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  • Analysis included equipment costs, capital depreciation, room set-up/takedown times, and personnel costs.

    • Main Results:

    • Mean set-up/takedown time was longer for CP (71 min) than LP (49 min).
    • Operating room times were 176 min for CP and 210 min for LP.
    • Cost analysis indicated LP is more cost-effective than CP, requiring significantly fewer annual cases for equivalence.

    Conclusions:

    • Computer-assisted pyeloplasty demonstrates encouraging perioperative parameters.
    • The higher costs associated with CP present a significant disadvantage compared to LP.
    • In this institution, purely laparoscopic pyeloplasty is more cost-effective to perform and teach.