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Robotic versus open pancreatic surgery: a propensity score-matched cost-effectiveness analysis
Christian Benzing1, Lea Timmermann2, Thomas Winklmann2
1Department of Surgery, Campus Charité Mitte, Campus Virchow-Klinikum, Experimental Surgery and Regenerative Medicine, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. christian.benzing@charite.de.
Robotic pancreatic surgery (RPS) has higher upfront costs but proves more cost-effective than open pancreatic surgery (OPS) due to shorter hospital stays and comparable outcomes. This analysis compared the two surgical approaches to determine overall cost-effectiveness.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Health Economics
Background:
- Robotic pancreatic surgery (RPS) presents higher intraoperative expenses than open pancreatic surgery (OPS).
- The potential for RPS to reduce total costs through decreased surgical trauma and faster recovery remains under investigation.
- Cost-effectiveness of RPS versus OPS requires comprehensive financial analysis.
Purpose of the Study:
- To compare the cost-effectiveness of robotic pancreatic surgery (RPS) against open pancreatic surgery (OPS).
- To analyze financial data including costs and revenues for both surgical approaches.
- To utilize propensity score-matched analysis for a robust comparison.
Main Methods:
- Retrospective analysis of OPS and RPS patients from 2017-2019.
- Financial data (costs, revenues, net profit/loss) were obtained from the controlling department.
- Propensity score-matched analysis (caliper 0.2) was performed using criteria: age, ASA score, gender, BMI, and resection type.
Main Results:
- Matched cohorts included 41 patients each; RPS group had a significantly shorter length of hospital stay (12 vs. 19 days, p=0.003).
- Major postoperative morbidity and 90-day mortality were similar between RPS and OPS (p>0.05).
- While intraoperative costs were higher for RPS (7334€ vs. 5115€, p<0.001), overall cost-effectiveness favored RPS (net profit: 57€ vs. -2894€, p=0.328).
Conclusions:
- Robotic pancreatic surgery demonstrates comparable surgical outcomes to open pancreatic surgery.
- The higher initial costs of RPS are offset by benefits in other financial aspects, particularly reduced length of hospital stay.
- RPS offers a potentially more cost-effective approach in pancreatic surgery despite higher intraoperative expenses.
