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Cost comparison of open and robotic partial nephrectomy using a short postoperative pathway
Roy Mano1, Ariel Schulman1, A Ari Hakimi1
1Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Urology
|January 15, 2015
Summary
Open partial nephrectomy (OPN) is less expensive than robotic partial nephrectomy (RPN) despite shorter hospital stays for RPN. High robotic costs make OPN more cost-effective in the immediate perioperative period.
Area of Science:
- Urology
- Health Economics
- Minimally Invasive Surgery
Background:
- Robotic partial nephrectomy (RPN) offers potential benefits like shorter hospital stays.
- Open partial nephrectomy (OPN) remains a common surgical approach for kidney tumors.
Purpose of the Study:
- To compare the immediate perioperative direct costs of OPN and RPN.
- To evaluate cost-effectiveness under a standardized care pathway.
Main Methods:
- Retrospective review of institutional cost data for 190 OPN and 63 RPN cases from 2011.
- Comparison of costs stratified by length of stay, ASA score, and RENAL nephrometry score.
Main Results:
- OPN had higher ASA scores and blood loss but shorter operative times.
- Median perioperative cost was $3091 lower for OPN ($10,881) versus RPN ($13,972).
- RPN incurred higher surgical costs, while OPN had higher hospitalization costs.
Conclusions:
- OPN is more cost-effective than RPN in the immediate perioperative period.
- High robotic acquisition and maintenance costs are key drivers of RPN's higher price.
- Financial barriers associated with robotic surgery may hinder the adoption of advanced medical technology.
