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Technical modifications for cost optimization in robot-assisted ventral mesh rectopexy: an initial experience.

A A Marra1, P Campennì1, V De Simone1

  • 1Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.

Techniques in Coloproctology
|February 21, 2023
PubMed
Summary
This summary is machine-generated.

Robot-assisted ventral mesh rectopexy can be made safer and more affordable through technical modifications. This study demonstrates that these surgical adjustments reduce costs without compromising patient safety for rectal prolapse treatment.

Keywords:
Cost analysisRectal prolapseRobotic surgeryVentral mesh rectopexy

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Technology
  • Colorectal Surgery

Background:

  • Robot-assisted ventral mesh rectopexy is a recognized treatment for rectal prolapse.
  • This robotic approach presents higher costs compared to laparoscopic surgery.
  • The study addresses the need for cost-effective robotic surgical options.

Purpose of the Study:

  • To evaluate the safety and cost-effectiveness of robot-assisted ventral mesh rectopexy.
  • To determine if technical modifications can reduce the expense of robotic rectal prolapse surgery.
  • To assess the feasibility of performing less expensive robotic surgery for rectal prolapse.

Main Methods:

  • Analysis of consecutive robot-assisted ventral mesh rectopexy cases at Fondazione Policlinico Universitario "A. Gemelli" IRCCS.
  • Cost evaluation of hospitalization, surgical procedures, robotic materials, and operating room resources.
  • Implementation and assessment of technical modifications: reduced robotic arms/instruments and alternative peritoneal incisions.

Main Results:

  • Twenty-two procedures were performed without major complications or conversions to open surgery.
  • Technical modifications significantly reduced overall hospitalization costs (€6604.5 vs €8755.0, p=0.001).
  • Modifications also decreased the number of robotic instruments used (3.1 vs 4.0, p=0.026) and operating room time (201 vs 253 min, p=0.003).

Conclusions:

  • Robot-assisted ventral mesh rectopexy, with specific technical modifications, can be a cost-effective treatment option.
  • The modified approach maintains safety standards for rectal prolapse repair.
  • These findings support the wider adoption of optimized robotic techniques in colorectal surgery.