Robotic versus laparoscopic surgery for rectal cancer: a comparative cost-effectiveness study

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Health Economics

Background:

• The comparative cost-effectiveness of robotic rectal resection (RRR) versus laparoscopic rectal resection (LRR) remains underexplored.
• Understanding these economic differences is crucial for surgical decision-making and resource allocation.

Purpose of the Study:

• To evaluate and compare the cost-effectiveness of robotic versus laparoscopic rectal resection.
• To determine the incremental cost-effectiveness ratio (ICER) for both surgical approaches.

Main Methods:

• An observational, comparative, prospective, non-randomized study was conducted.
• Patients undergoing RRR and LRR between February 2014 and March 2018 were analyzed.
• Outcome parameters included surgical/post-operative costs, quality-adjusted life years (QALY), and ICER, with willingness-to-pay thresholds of €20,000 and €30,000 per QALY.

Main Results:

• Mean operative costs were higher for RRR (€4307.09) than LRR (€3834.58), but overall costs were similar (RRR: €7272.03 vs LRR: €6968.63).
• Mean QALYs at 1 year were significantly higher for RRR (0.8482) compared to LRR (0.6532).
• At willingness-to-pay thresholds of €20,000 and €30,000, RRR showed a 95.54% and 97.18% probability, respectively, of being more cost-effective than LRR.

Conclusions:

• Robotic rectal resection demonstrates a clear benefit in terms of cost-effectiveness compared to laparoscopic rectal resection.
• The higher QALYs gained with RRR justify its adoption, particularly at standard willingness-to-pay thresholds.