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Robotic versus laparoscopic radical nephrectomy: comparative analysis and cost considerations.

Mark R Helmers¹, Mark W Ball, Michael A Gorin

¹The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

The Canadian Journal of Urology

|October 6, 2016

Summary

Robotic-assisted radical nephrectomy (RRN) is comparable to laparoscopic radical nephrectomy (LRN) in patient outcomes. However, RRN is associated with higher hospital charges and increased rates of blood loss and conversion to open surgery.

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Area of Science:

Urology
Minimally Invasive Surgery
Surgical Oncology

Background:

Robotic-assisted radical nephrectomy (RRN) is increasingly used, but comparative data on effectiveness and cost versus laparoscopic radical nephrectomy (LRN) is limited.
This study addresses the need for comparative analysis of perioperative outcomes and hospital charges between RRN and LRN.

Purpose of the Study:

To compare perioperative outcomes and hospital charges between robotic-assisted radical nephrectomy (RRN) and laparoscopic radical nephrectomy (LRN).

Main Methods:

A retrospective analysis of the institutional renal mass registry from 2010 to 2014.
Comparison of demographic, perioperative outcomes, and hospital charge data between LRN and RRN patient groups.

Main Results:

No significant differences in operative time, intraoperative complications, or length of stay between LRN and RRN.
RRN showed higher estimated blood loss and conversion rates, and increased lymph node dissection compared to LRN.
Hospital charges trended higher for RRN but did not reach statistical significance.

Conclusions:

Robotic-assisted radical nephrectomy (RRN) is a clinically equivalent alternative to laparoscopic radical nephrectomy (LRN) regarding perioperative outcomes.
RRN is associated with greater hospital charges compared to LRN.
Further research may be needed to fully elucidate cost-effectiveness and optimize RRN utilization.