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Updated: Nov 17, 2025

Subcostal Specimen Removal in Completely Portal Robotic Lobectomy

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Published on: April 19, 2024

Activity-Based Cost Analysis of Robotic Anatomic Lung Resection During Program Implementation.

Garrett N Coyan¹, Michael Lu¹, Kristine M Ruppert²

¹Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

The Annals of Thoracic Surgery

|February 18, 2021

Summary

This summary is machine-generated.

Robotic-assisted lung resection (RALS) offers comparable clinical outcomes to video-assisted thoracoscopic surgery (VATS) with potentially lower controllable costs. This approach can be cost-advantageous within existing minimally invasive programs.

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Area of Science:

Thoracic Surgery
Minimally Invasive Surgery
Robotic Surgery

Background:

Robotic-assisted lung resection adoption is increasing, but concerns about initial outcomes and costs persist.
This study evaluates the initial outcomes and cost-effectiveness of a newly established robotic lung resection program.

Purpose of the Study:

To compare perioperative and 30-day outcomes between robotic-assisted lobectomy/segmentectomy (RALS) and video-assisted thoracoscopic lobectomy/segmentectomy (VATS).
To conduct a detailed cost analysis of RALS versus VATS, including direct and indirect controllable costs.

Main Methods:

Retrospective review of patients undergoing RALS or VATS between August 2014 and January 2017.
1:1 propensity matching based on preoperative characteristics.
Activity-based costing analysis of individual patient encounters.

Main Results:

No significant difference in 30-day mortality between RALS and VATS groups (0% vs 1.4%).
RALS demonstrated a decreased median length of stay (4 vs 7 days) and chest tube duration (3 vs 5 days).
Overall median controllable costs were significantly lower for RALS ($16,352) compared to VATS ($21,154).

Conclusions:

A robotic-assisted pulmonary resection program can be cost-advantageous while maintaining good clinical outcomes compared to VATS.
Process-of-care changes in RALS may contribute to reduced costs in this setting.