Favorable Impact of Cost-Conscious Robotic Colectomy on Hospital Gross Profit: A Retrospective Cohort Study

In Japan, rising healthcare costs and hospital deficits require both systemic reforms and institutional efforts to reduce expenditure. Robotic surgery has been increasingly adopted owing to its precision and stability, and insurance coverage for colectomies began in April 2022. Nonetheless, the high cost and maintenance of robotic instruments have substantially reduced the hospital gross profit. We previously reported that robotic colectomy decreased the gross profit by approximately JPY 212 000 compared with laparoscopic colectomy.

To address this issue, we implemented a hybrid robotic colectomy technique incorporating the double bipolar method and using laparoscopic coagulating shears instead of robotic advanced energy devices. Additionally, bowel transection and anastomosis were performed by an assistant using a laparoscopic stapler.

Standardization of the surgical procedure contributed to reduced operative time. Comparisons before and after the introduction of this strategy revealed no significant differences in clinical or oncological factors or short-term outcomes. However, the operative time was significantly reduced, and the gross profit improved by approximately JPY 120 000. This improvement resulted from lower material and labor costs, with the latter being due to the shorter operative time.

Our experience highlights that cost reduction in robotic colectomy can be safely achieved without compromising clinical outcomes. Continued efforts to optimize surgical efficiency and cost-effectiveness will benefit patients and healthcare institutions.