Merola, Giovanni, Sciuto, Antonio, Pirozzi, Felice, Andreuccetti, Jacopo, Pignata, Giusto, Corcione, Francesco, Milone, Marco, Domenico De Palma, Giovanni, Castaldo, Rossana, Pecchia, Leandro, Ceccarelli, Graziano and Bracale, Umberto (2020) Is robotic right colectomy economically sustainable? A multicentre retrospective comparative study and cost analysis. Surgical Endoscopy, 34 . pp. 4041-4047. doi:10.1007/s00464-019-07193-z ISSN 0930-2794.

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Abstract

Background
Following the Food and Drug Administration approval, robot-assisted colorectal surgery has gained more acceptance among surgeons. One of the open issues about robotic surgery is the economic sustainability. The aim of our study is to evaluate the economic sustainability of robotic as compared to laparoscopic right colectomy for the Italian National Health System.

Methods
We performed a retrospective multicentre case-matched study including 94 patients for each group from four different Italian surgical departments. An economic evaluation gathered from a real-world data was performed to assess the sustainability of the robotic approach for right colectomy in the Italian National Health System. In particular, a differential cost analysis between the two procedures was performed.

Results
No statistical differences were found between the two groups for postoperative outcomes. After a careful review of the literature on the cost assessment for the operative room, medical devices and hospital stay according with our data, we estimated the followings: (a) the mean operative room cost for robotic group was 2179 ± 476 € vs. 1376 ± 322 € for laparoscopic group; (b) the mean hospital stay cost for robotic group was 3143 ± 1435 € vs. 3292 ± 1123 € for laparoscopic group; and (c) the mean cost for instruments was 6280 € for robotic group vs. 1504 € for laparoscopic group. The total mean cost of robotic right colectomy was 11,576 ± 1915 € vs. 6196 ± 1444 € for laparoscopic right colectomy.

Conclusion
In conclusion, to date, robotic right colectomy with intracorporeal anastomosis does not provide any significant clinical advantages, which may justify the additional costs, as compared to its laparoscopic counterpart. Further evolution of robotic technology and experience may lead to a reduction of costs, especially if the robotic platform is used in an appropriate healthcare setting.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General) R Medicine > RD Surgery T Technology > TJ Mechanical engineering and machinery
Divisions:	Faculty of Science, Engineering and Medicine > Engineering > Engineering
Library of Congress Subject Headings (LCSH):	Colectomy , Colon (Anatomy) -- Surgery, Robotics , Surgical robots , Robotics in medicine
Journal or Publication Title:	Surgical Endoscopy
Publisher:	Springer New York LLC
ISSN:	0930-2794
Official Date:	September 2020
Dates:	Date Event September 2020 Published 15 October 2019 Available 5 October 2019 Accepted
Volume:	34
Page Range:	pp. 4041-4047
DOI:	10.1007/s00464-019-07193-z
Status:	Peer Reviewed
Publication Status:	Published
Reuse Statement (publisher, data, author rights):	This is a post-peer-review, pre-copyedit version of an article published in Surgical Endoscopy. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00464-019-07193-z
Access rights to Published version:	Restricted or Subscription Access
Date of first compliant deposit:	8 October 2019
Date of first compliant Open Access:	15 October 2020
Related URLs:	Publisher

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