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Cost analysis of training residents in robotic-assisted surgery

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Abstract

Introduction

Use of robotic-assisted surgery is increasing, and resident involvement may lead to higher costs. We investigated whether senior resident involvement in noncomplex robotic cholecystectomy (RC) and inguinal hernia (RIH) would take more time and cost more when compared to non-robotic cholecystectomy (NRC) and inguinal hernia repair (NRIH).

Methods

We extracted surgery duration and total cost of NRC, NRIH, RC, and RIH from 7/2016 to 6/2020 with senior resident (PGY4-5) involvement. We excluded complex cases as well as prisoner cases and those with new faculty and research residents. We assessed differences between robotic and non-robotic cases in surgery duration and total cost per minute, using one-way ANOVA.

Results

We included 1608 cases (non-robotic 1145 vs. robotic 463). On average, RC cases with a senior resident took less time than NRC (179.4 < 185.8, p = 0.401); surgery duration of RIH cases was similar with NRIH cases. The total cost per minute of RC cases with a senior resident on average was $9.30 higher than NRC cases for each minute incurred in the operating room but did not lead to a significant change in overall cost. RIH cases, on the other hand, cost less per minute than NRIH cases (114.1 < 126.5, p = 0.399).

Conclusion

Training in robotic surgery is important. Noncomplex RC and RIH involving senior residents were not significantly longer nor did they incur significantly more cost than non-robotic procedures. Senior resident training in noncomplex robotic surgery can be efficient and can be included in the residency curriculum.

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Funding

This project was supported by Award Number UL1TR002733 from the National Center for Advancing Translational Sciences. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Advancing Translational Sciences or the National Institutes of Health.

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Authors and Affiliations

  1. Department of Surgery, The Ohio State University, 395 W 12thAve FOT Suite 664, Columbus, OH, 43210, USA

    Xiaodong Chen, Michael Meara, Alan Harzman, Heidi Pieper & E Christopher Ellison

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  1. Xiaodong Chen
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  2. Michael Meara
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  3. Alan Harzman
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  4. Heidi Pieper
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  5. E Christopher Ellison
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Correspondence to Xiaodong Chen.

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Disclosures

Dr. Xiaodong (Phoenix) Chen receives grants from AMA and Intuitive Foundation and is on the Editorial Board of Global Surgical Education—Journal of the Association for Surgical Education. Dr. Ellison receives royalties from McGraw Hill and Wolters Kluwer and is the ACS President and on the ASA Council and Foundation Board. Dr. Meara receives a grant and honoraria from Intuitive Foundation. Dr. Harzman and Ms. Pieper have no conflicts of interest or financial ties to disclose.

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Chen, X., Meara, M., Harzman, A. et al. Cost analysis of training residents in robotic-assisted surgery. Surg Endosc 37, 2765–2769 (2023). https://doi.org/10.1007/s00464-022-09794-7

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