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Technical Detail for Robot Assisted Pancreaticoduodenectomy
Published on: September 28, 2019
Comparing economic viability and peri-operative outcomes of open and robotic-assisted partial nephrectomy
Fintan R Ryan1, Gavin C Calpin1, Sorcha O'Meara2
1Department of Urology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Introduction:
Robotic-assisted partial nephrectomy (RAPN) is an established technique for managing early-stage renal cell carcinomas. RAPN is associated with shorter length of stay (LOS) and fewer complications, suggesting potential economic benefits. This study compares the cost-effectiveness of RAPN with open partial nephrectomy (OPN).
Methods:
We retrospectively reviewed 184 RAPNs performed at our centre (2016-2022) and compared them with 2146 OPNs from the BAUS Nephrectomy Registry (2012, 2016-2019). Cost analysis was based on data from our finance department and the Healthcare Pricing Office. Sensitivity analyses were conducted to account for capital and consumable costs.
Results:
Median LOS was shorter for RAPN (3 days) than OPN (5 days). Significant complications (Clavien-Dindo >2) were less frequent in RAPN (3.26%) than OPN (10.6%). Blood transfusions occurred in 4.47% of RAPN patients versus 10.6% of OPN patients. Costs included €2237.42 per hospital bed day and €336 per blood transfusion unit, with the Da Vinci Xi's annual maintenance at €150,000. Mean costs were €9988.47 for RAPN and €12,032.14 for OPN.
Conclusions:
RAPN demonstrates superior peri-operative outcomes and shorter LOS. Increasing RAPN volumes may enhance its cost-effectiveness as fixed costs decrease.
