Robotic-Assisted Surgery for Radical Nephrectomy: Outcomes and Costs
Although the use of robotic-assisted surgery for radical nephrectomy (RN) has increased substantially, researchers from the University of Ulsan College of Medicine in Seoul, South Korea, and other institutions have found it is associated with prolonged operating times and higher hospital costs. The study, published in JAMA, noted that robotic-assisted surgery was not likely associated with an increased risk of any or major complications compared with conventional laparoscopic surgery.
In this retrospective study of 23,753 patients, Gab Jeong, MD, PhD, and colleagues found that the use of robotic-assisted RN grew from 39 of 2676 (1.5%) RN procedures in 2003 to 862 of 3194 (27%) RN procedures in 2015. However, with the increased employment of robotic-assisted surgery for RN, the investigators concluded the rate of prolonged operating time (defined as longer than 4 hours) was greater for the robotic-assisted surgery than the laparoscopic procedure (46.3% vs. 25.8%).
In addition, the mean 90-day direct hospital costs were significantly higher for robotic-assisted than laparoscopic RN ($19,530 vs. $16,851), which included higher operating room costs ($7217 vs. $5378) and higher supply costs ($4876 vs. $3891). “Surgeons have to perform at least 100 to 150 procedures annually to offset the upfront and ongoing costs of its [robotic-assisted surgery] acquisition,” Dr. Jeong and colleagues noted in Renal & Urology News.