Performing robotic lobectomy and segmentectomy: cost, profitability, and outcomes

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robotic pulmonary resections, including lobectomy and segmentectomy, are increasingly utilized.
• Evaluating the experience with a completely portal robotic approach is crucial for understanding its efficacy.

Purpose of the Study:

• To assess the outcomes and financial viability of completely portal robotic pulmonary lobectomy and segmentectomy.
• To determine the safety and effectiveness of this minimally invasive technique.

Main Methods:

• Retrospective review of a consecutive series of patients undergoing robotic pulmonary resections.
• Analysis of surgical outcomes, including morbidity, mortality, hospital stay, and pain scores.
• Evaluation of financial data, including hospital charges, costs, and profitability.

Main Results:

• 862 robotic operations were performed, with 394 anatomic pulmonary resections (282 lobectomies, 71 segmentectomies).
• Malignancy was the indication in 88% of cases, with a median of 17 lymph nodes removed.
• Low morbidity (9.6%), operative mortality (0.25% at 30 days), and median pain score (2/10 at 3 weeks) were observed.
• The procedure demonstrated hospital profitability with a median profit of $4,750 per patient.

Conclusions:

• Completely portal robotic lobectomy for lung cancer yields outstanding results, including effective lymph node dissection and low morbidity/mortality.
• Despite initial costs and a learning curve, robotic surgery is profitable for hospitals and a valuable tool for thoracic surgeons.
• The precise role of robotic surgery in thoracic procedures is still evolving, with limitations such as the lack of tactile feedback.