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European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 10, pp 2825–2834 | Cite as

Cost comparison of open approach, transoral laser microsurgery and transoral robotic surgery for partial and total laryngectomies

  • Manon Dombrée
  • Ralph Crott
  • Georges Lawson
  • Pascal Janne
  • Annick Castiaux
  • Bruno KrugEmail author
Miscellaneous

Abstract

Activity-based costing is used to give a better insight into the actual cost structure of open, transoral laser microsurgery (TLM) and transoral robotic surgery (TORS) supraglottic and total laryngectomies. Cost data were obtained from hospital administration, personnel and vendor structured interviews. A process map identified 17 activities, to which the detailed cost data are related. One-way sensitivity analyses on the patient throughput, the cost of the equipment or operative times were performed. The total cost for supraglottic open (135–203 min), TLM (110–210 min) and TORS (35–130 min) approaches were 3,349 € (3,193–3,499 €), 3,461 € (3,207–3,664 €) and 5,650 € (4,297–5,974 €), respectively. For total laryngectomy, the overall cost were 3,581 € (3,215–3,846 €) for open and 6,767 € (6,418–7,389 €) for TORS. TORS cost is mostly influenced by equipment (54 %) where the other procedures are predominantly determined by personnel cost (about 45 %). Even when we doubled the yearly case-load, used the shortest operative times or a calculation without robot equipment costs we did not reach cost equivalence. TORS is more expensive than standard approaches and mainly influenced by purchase and maintenance costs and the use of proprietary instruments. Further trials on long-term outcomes and costs following TORS are needed to evaluate its cost-effectiveness.

Keywords

Cost analysis Activity-based costing Laryngeal cancer Laryngectomy Robotic surgery 

Notes

Conflict of interest

Hereby, all authors declare that we do not have any conflicts of interest in the manuscript, including financial, consultant, institutional and other relationships that might lead to bias or a conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Manon Dombrée
    • 1
  • Ralph Crott
    • 6
  • Georges Lawson
    • 2
    • 3
  • Pascal Janne
    • 2
    • 4
  • Annick Castiaux
    • 1
    • 2
  • Bruno Krug
    • 2
    • 4
    • 5
    • 6
    Email author
  1. 1.Business Administration DepartmentUniversity of NamurNamurBelgium
  2. 2.Namur Research Institute for Life SciencesUniversity of NamurNamurBelgium
  3. 3.Department of Head and Neck SurgeryCHU UCL Mont-Godinne–DinantYvoirBelgium
  4. 4.AdministrationCHU UCL Mont-Godinne–DinantYvoirBelgium
  5. 5.Nuclear Medicine DivisionCHU UCL Mont-Godinne–Dinant, Université Catholique de LouvainYvoirBelgium
  6. 6.Institute of Health and SocietyUniversité Catholique de LouvainYvoirBelgium

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