Is robotic mitral valve surgery more expensive than its conventional counterpart?

Area of Science:

• Cardiac Surgery
• Minimally Invasive Surgery
• Health Economics

Background:

• Robotic surgery is perceived as more expensive than traditional methods.
• There is limited data on the cost-effectiveness of robotic cardiac procedures.

Purpose of the Study:

• To compare the total cost of robotic mitral valve surgery versus conventional sternotomy.
• To analyze the impact of operational and postoperative costs, including amortization, on the overall expense.

Main Methods:

• Systematic review of 5 studies providing best evidence on the topic.
• Analysis of operational theatre costs, postoperative care costs, and hospital stay duration.
• Inclusion of amortization costs in the financial comparison.

Main Results:

• Robotic surgery has higher operating theatre costs due to instruments and longer procedure times.
• Postoperative savings are observed in robotic cases, including shorter hospital stays and reduced morbidity.
• Overall hospital costs are similar when amortization is excluded, but robotic surgery is significantly more expensive when included (US$3400-US$3700 per case).

Conclusions:

• Robotic mitral valve surgery incurs slightly higher total hospital costs than conventional sternotomy.
• Amortization significantly increases the cost-effectiveness gap, making robotic surgery considerably more expensive.