Robotic-assisted right colectomy versus laparoscopic approach: case-matched study and cost-effectiveness analysis

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Health Economics

Background:

• Robot-assisted surgery is increasingly adopted for colectomies.
• Conventional laparoscopy is the current standard for right colectomy.
• Comparative cost-effectiveness data for these techniques are limited.

Purpose of the Study:

• To compare clinical and oncological outcomes of robot-assisted right colectomy versus laparoscopy-assisted right colectomy.
• To conduct the first cost-effectiveness analysis comparing these two surgical approaches.
• To evaluate the probability of robot-assisted colectomy being cost-effective.

Main Methods:

• Prospective, non-randomized, case-matched study (1:1) of 70 patients (35 robotic, 35 laparoscopic).
• Inclusion criteria: right-sided colonic adenocarcinoma or adenoma not suitable for endoscopic resection.
• Analysis included perioperative, postoperative, long-term oncological results, costs, Quality-Adjusted Life Years (QALY), and Incremental Cost-Effectiveness Ratio (ICER).

Main Results:

• Robot-assisted colectomy had longer operation times (243 min vs. 179 min, p < 0.001).
• No significant difference in total costs between robotic and laparoscopic groups (p = 0.21).
• Probabilistic analysis showed a 78.78-95.04% likelihood of robotic colectomy being cost-effective at willingness-to-pay thresholds of $20,000-$30,000 per QALY.

Conclusions:

• Robot-assisted right colectomy is a safe and feasible surgical option.
• The procedure demonstrates cost-effectiveness compared to laparoscopy for right colectomy.
• Robotic surgery offers a viable, economically sound alternative for selected colectomy patients.