Advertisement

World Journal of Surgery

, Volume 36, Issue 11, pp 2722–2729 | Cite as

Robotic versus Conventional Laparoscopic Surgery for Rectal Cancer: A Cost Analysis from A Single Institute in Korea

  • Se-Jin Baek
  • Seon-Hahn KimEmail author
  • Jae-Sung Cho
  • Jae-Won Shin
  • Jin Kim
Article

Abstract

Background

Since its introduction, robotic surgery has been applied actively in several fields of minimally invasive surgery, and its use in the field of colorectal surgery is also increasing. In the studies to date, feasibility and safety have been the main focus, but the economics involved are important to examine. We compared the economics of robotic surgery with those of laparoscopic surgery for rectal cancer.

Material and methods

We analyzed the clinical characteristics, total hospital charges, payments, operating room costs, and hospital profits for patients who underwent robotic and laparoscopic resection of rectal cancer at Korea University Anam Hospital between July 2007 and August 2010.

Results

From July 2007 and August 2010, 154 robot-assisted and 150 laparoscopic rectal surgeries were performed. The patient demographics were similar in the two groups with the exception of tumor location (6.7 vs 8.7 cm distal to the anal verge; p = 0.043), preoperative chemoradiotherapy (22.7 vs 8 %; p = 0.001), and operative time (285.2 vs 219.7 min; p = 0.018). Postoperative course and complications were also similar in the two groups. The total hospital charges in U.S. dollars ($14,647 vs $9,978; p = 0.001) and payments made by patients ($11,540 vs $3,956; p < 0.001) were significantly higher in the robotic group. Hospital profit was significantly lower in the robotic group than in the laparoscopic group ($689 vs $1,671; p < 0.001).

Conclusions

Robot-assisted surgery is more expensive than laparoscopic surgery for rectal cancer. Considering that robotic surgery can be applied more easily for low-lying cancers, the cost-effectiveness of robotic rectal cancer surgery should be assessed based on oncologic outcomes and functional results from future studies.

Keywords

Rectal Cancer Operating Room Robotic Surgery Laparoscopic Group Robotic Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1:144–150PubMedGoogle Scholar
  2. 2.
    Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRefGoogle Scholar
  3. 3.
    Lacy AM, Garcia-Valdecasas JC, Delgado S et al (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359:2224–2229PubMedCrossRefGoogle Scholar
  4. 4.
    Leung KL, Kwok SP, Lam SC et al (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 363:1187–1192PubMedCrossRefGoogle Scholar
  5. 5.
    Ficarra V, Cavalleri S, Novara G et al (2007) Evidence from robot-assisted laparoscopic radical prostatectomy: a systematic review. Eur Urol 51:45–55 (discussion 56)PubMedCrossRefGoogle Scholar
  6. 6.
    Advincula AP, Song A (2007) The role of robotic surgery in gynecology. Curr Opin Obstet Gynecol 19:331–336PubMedCrossRefGoogle Scholar
  7. 7.
    Gao C, Yang M, Wu Y et al (2009) Hybrid coronary revascularization by endoscopic robotic coronary artery bypass grafting on beating heart and stent placement. Ann Thorac Surg 87:737–741PubMedCrossRefGoogle Scholar
  8. 8.
    Baik SH, Lee WJ, Rha KH et al (2008) Robotic total mesorectal excision for rectal cancer using four robotic arms. Surg Endosc 22:792–797PubMedCrossRefGoogle Scholar
  9. 9.
    Ng KH, Lim YK, Ho KS et al (2009) Robotic-assisted surgery for low rectal dissection: from better views to better outcome. Singap Med J 50:763–767Google Scholar
  10. 10.
    Park JS, Choi GS, Lim KH et al (2010) Robotic-assisted versus laparoscopic surgery for low rectal cancer: case-matched analysis of short-term outcomes. Ann Surg Oncol 17:3195–3202PubMedCrossRefGoogle Scholar
  11. 11.
    Kwak JM, Kim SH, Kim J et al (2011) Robotic versus laparoscopic resection of rectal cancer: short-term outcomes of a case-control study. Dis Colon Rectum 54:151–156PubMedCrossRefGoogle Scholar
  12. 12.
    Park JS, Choi GS, Lim KH et al (2011) S052: a comparison of robot-assisted, laparoscopic, and open surgery in the treatment of rectal cancer. Surg Endosc 25:240–248PubMedCrossRefGoogle Scholar
  13. 13.
    Leong QM, Son DN, Cho JS et al (2011) Robot-assisted intersphincteric resection for low rectal cancer: technique and short-term outcome for 29 consecutive patients. Surg Endosc 25:2987–2992PubMedCrossRefGoogle Scholar
  14. 14.
    Barbash GI, Glied SA (2010) New technology and health care costs—the case of robot-assisted surgery. N Engl J Med 363:701–704PubMedCrossRefGoogle Scholar
  15. 15.
    Morgan JA, Thornton BA, Peacock JC et al (2005) Does robotic technology make minimally invasive cardiac surgery too expensive? A hospital cost analysis of robotic and conventional techniques. J Cardiac Surg 20:246–251CrossRefGoogle Scholar
  16. 16.
    Burgess SV, Atug F, Castle EP et al (2006) Cost analysis of radical retropubic, perineal, and robotic prostatectomy. J Endourol 20:827–830PubMedCrossRefGoogle Scholar
  17. 17.
    Bolenz C, Gupta A, Hotze T et al (2010) Cost comparison of robotic, laparoscopic, and open radical prostatectomy for prostate cancer. Eur Urol 57:453–458PubMedCrossRefGoogle Scholar
  18. 18.
    Martin AD, Nunez RN, Castle EP (2011) Robot-assisted radical cystectomy versus open radical cystectomy: a complete cost analysis. Urology 77:621–625PubMedCrossRefGoogle Scholar
  19. 19.
    Sarlos D, Kots L, Stevanovic N et al (2010) Robotic hysterectomy versus conventional laparoscopic hysterectomy: outcome and cost analyses of a matched case–control study. Eur J Obstet Gynecol Reprod Biol 150:92–96PubMedCrossRefGoogle Scholar
  20. 20.
    Waters JA, Canal DF, Wiebke EA et al (2010) Robotic distal pancreatectomy: cost effective? Surgery 148:814–823PubMedCrossRefGoogle Scholar
  21. 21.
    Hottenrott C (2011) Robotic versus laparoscopic surgery for rectal cancer and cost-effectiveness analysis (letter). Surg Endosc 25:3954–3956PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Se-Jin Baek
    • 1
  • Seon-Hahn Kim
    • 1
    Email author
  • Jae-Sung Cho
    • 1
  • Jae-Won Shin
    • 1
  • Jin Kim
    • 1
  1. 1.Colorectal Division, Department of SurgeryKorea University Anam Hospital, Korea University College of MedicineSeoulKorea

Personalised recommendations