Robotic and endoscopic transaxillary thyroidectomies may be cost prohibitive when compared to standard cervical...

Area of Science:

• Surgical Oncology
• Cost Analysis
• Minimally Invasive Surgery

Background:

• Thyroidectomy is a common surgical procedure.
• Minimally invasive techniques offer potential benefits but may incur higher costs.
• Cost-effectiveness of different thyroidectomy approaches requires evaluation.

Purpose of the Study:

• To compare the medical costs of standard cervical, gasless transaxillary endoscopic, and gasless transaxillary robotic thyroidectomy in the US.
• To identify cost drivers for each surgical approach.
• To assess the impact of operative time on cost differences.

Main Methods:

• Retrospective review of 140 thyroidectomy patients across two tertiary centers.
• Cost model included operating room, anesthesia, consumables, equipment, and maintenance expenses.
• Sensitivity analyses were performed on individual cost variables.

Main Results:

• Transaxillary endoscopic and robotic thyroidectomies were significantly more expensive than the standard cervical approach.
• Mean costs were $9,028 (cervical), $12,505 (endoscopic), and $13,670 (robotic).
• Cost parity was achieved with reduced operative times for transaxillary methods.

Conclusions:

• Transaxillary endoscopic and robotic thyroidectomy present higher costs compared to the standard cervical method.
• Reducing operative times is key to mitigating the cost disparity.
• High costs may limit the adoption of transaxillary approaches in certain healthcare systems.