Robotic Versus Video-Assisted Thoracoscopic Surgery Pulmonary Segmentectomy: A Cost Analysis

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Robotic-assisted pulmonary segmentectomy is perceived as more expensive than video-assisted thoracic surgery.
• Robotic techniques may offer advantages in dissection, potentially reducing parenchymal injuries and air leaks.
• Shorter length of stay is a potential benefit of robotic procedures.

Purpose of the Study:

• To compare the direct costs of pulmonary segmentectomy using video-assisted thoracic surgery (VATS) versus robotic assistance with manual staplers versus robotic assistance with robotic staplers.
• To evaluate early outcomes, including length of stay and complications, for robotic versus VATS segmentectomy.

Main Methods:

• Retrospective analysis of 50 anatomical segmentectomies (28 robotic, 22 VATS) over 30 months.
• Procedure-specific direct cost evaluation, including instruments, staplers, and hospital length of stay.
• Comparison of patient demographics, costs, and length of stay between robotic and VATS groups.

Main Results:

• The median length of stay was shorter for robotic segmentectomy (2 days) compared to VATS (4 days).
• Robotic segmentectomy with manual staplers was less expensive than with robotic staplers.
• Both robotic techniques were found to be less expensive than VATS segmentectomy.

Conclusions:

• In this early experience, robotic-assisted segmentectomy showed comparable costs and outcomes to VATS.
• Trends suggest shorter length of stay and fewer complications with robotic assistance.
• Larger studies are required to validate these preliminary findings.