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Optimizing outcomes in colorectal surgery: cost and clinical analysis of robotic versus laparoscopic approaches to colon resection

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Abstract

The use of robotics in colorectal surgery has been steadily increasing, however, reported longer operative times and increased cost has limited its widespread adoption. We investigated the cost of elective colorectal surgery based on type of anatomic resection and the impact of a standardized protocol for robotic colectomies. A retrospective review was conducted of 279 elective colectomies at a single institution between 2013 and 2017. Clinical outcomes and detailed cost data were compared based on open, laparoscopic, or robotic surgical approach and stratified by anatomic resection. Robotic, laparoscopic and open colectomy rates were 35, 34 and 31%, respectively. While total costs were similar in robotic and laparoscopic surgery, anatomic resection stratification showed that low anterior resection (LAR) was significantly cheaper ($14,093 vs $17,314). When a standardized surgical protocol was implemented for robotic colectomies, significant reductions in operative times, length of stay, total cost, and operative cost were observed. Robotic surgery may be most cost effective for elective LAR compared to laparoscopic or open approaches. A standardized surgical protocol for robotic surgery may help reduce costs by reducing operative times, operating rooms expenditure, and lengths of stay.

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Funding

This research was supported in part by the National Institutes of Diabetes and Digestive and Kidney Disease of the National Institutes of Health (grant number T32DK007639).

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Authors and Affiliations

  1. Department of Surgery, University of Texas Medical Branch, 301 University Dr, Galveston, TX, 77555, USA

    Kevin J. Hancock, V. Suzanne Klimberg, Omar Nunez-Lopez, Aakash H. Gajjar, Guillermo Gomez & Douglas S. Tyler

  2. PRiSMA Proctology Surgical Medicine & Associates, PLLC, Houston, TX, USA

    Aakash H. Gajjar

  3. Department of Surgery, Multicare Health System, 3124 19th St. Suite 220, Tacoma, WA, 98405, USA

    Laila Rashidi

Authors
  1. Kevin J. Hancock
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  2. V. Suzanne Klimberg
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  3. Omar Nunez-Lopez
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  4. Aakash H. Gajjar
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  5. Guillermo Gomez
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  6. Douglas S. Tyler
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  7. Laila Rashidi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by LR and ON-L. The first draft of the manuscript was written by KH and SK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Laila Rashidi.

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All of the authors declare that they have no conflicts of interest or financial ties to disclose.

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Hancock, K.J., Klimberg, V.S., Nunez-Lopez, O. et al. Optimizing outcomes in colorectal surgery: cost and clinical analysis of robotic versus laparoscopic approaches to colon resection. J Robotic Surg 16, 107–112 (2022). https://doi.org/10.1007/s11701-021-01205-8

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  • DOI: https://doi.org/10.1007/s11701-021-01205-8

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