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 26 May 2018

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News

Robotic-assisted vs laparoscopic cholecystectomy

June‘s issue of the Annals of Surgery compares robotic-assisted with laparoscopic cholecystectomy.

News image

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Pressure is currently applied to decrease costs, leading to restriction of development, and implementation of new technologies.

So far, no convincing data are available comparing outcome or costs between computer assisted and conventional laparoscopic cholecystectomy.

Dr Stefan Breitenstein and colleagues compared safety and costs of robotic-assisted and laparoscopic cholecystectomy in patients with symptomatic cholecystolithiasis.

The team documented technical benefits of robotic-assisted surgery.

Hospital costs were higher for robotic-assisted cholecystectomy, at $7,985
Annals of Surgery

The team conducted a prospective case-matched study on 50 consecutive patients, who underwent robotic-assisted cholecystectomy between 2004 and 2006.

These patients were matched to 50 patients with conventional laparoscopic cholecystectomy, according to age, gender, American Society of Anesthesiologists score, histology, and surgical experience.

The team's endpoints were complications after surgery, conversion rates, operative time, and hospital costs.

The researchers found no minor complications, but major complications occurred in 2% of each group.

No conversion to open surgery was needed in either group.

Operation time, and hospital stay were similar.

The research team found that overall hospital costs were significantly higher for robotic-assisted cholecystectomy, at $7,985 vs $6,255 for laparoscopic cholecystectomy.

The raw difference was $1,730, and the difference after adjusting for confounders was $1,606.

The researchers noted that this difference was mainly related to the amortization, and consumables of the robotic system.

Dr Breitenstein‘s team concluded, "Robotic-assisted cholecystectomy is safe and, therefore, a valuable approach."

"Costs of robots, however, are high and do not justify the use of this technology considering the lack of benefits for patients."

"A reduction of acquisition and maintenance costs for the robotic system is a prerequisite for large-scale adoption and implementation."

Ann Surg 2008: 247(6): 987-93
30 May 2008

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