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Workplace absenteeism amongst patients undergoing open vs. robotic radical prostatectomy, hysterectomy, and partial colectomy

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Abstract

Background

There is controversy regarding the widespread uptake of robotic surgery across several surgical disciplines. While it has been shown to confer clinical benefits such as decreased blood loss and shorter hospital stays, some argue that the benefits of this technology do not outweigh its high cost. We performed a retrospective insurance-based analysis to investigate how undergoing robotic surgery, compared to open surgery, may impact the time in which an employed individual returns to work after undergoing major surgery.

Methods

We identified a cohort of US adults with employer-sponsored insurance using claims data from the MarketScan database who underwent either open or robotic radical prostatectomy, hysterectomy/myomectomy, and partial colectomy from 2012 to 2016. We performed multiple regression models incorporating propensity scores to assess the effect of robotic vs. open surgery on the number of absent days from work, adjusting for demographic characteristics and baseline absenteeism.

Results

In a cohort of 1157 individuals with employer-sponsored insurance, those undergoing open surgery, compared to robotic surgery, had 9.9 more absent workdays for radical prostatectomy (95%CI 5.0 to 14.7, p < 0.001), 25.3 for hysterectomy/myomectomy (95%CI 11.0–39.6, p < 0.001), and 29.8 for partial colectomy (95%CI 14.8–44.8, p < 0.001)

Conclusion

For the three major procedures studied, robotic surgery was associated with fewer missed days from work compared to open surgery. This information helps payers, patients, and providers better understand some of the indirect benefits of robotic surgery relative to its cost.

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Author information

Author notes

  1. Prokar Dasgupta and Quoc-Dien Trinh equally contributing as senior authors

Authors and Affiliations

  1. Division of Urology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Daniel Pucheril, Sean A. Fletcher, Xi Chen, David F. Friedlander, Alexander P. Cole, Marieke J. Krimphove, Adam S. Kibel & Quoc-Dien Trinh

  2. James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MA, USA

    Sean A. Fletcher

  3. Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Xi Chen & Nelya Melnitchouk

  4. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany

    Marieke J. Krimphove

  5. Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Adam C. Fields & Nelya Melnitchouk

  6. MRC Centre for Transplantation, NIHR Biomedical Research Centre, King’s College, London, UK

    Prokar Dasgupta

  7. Division of Urological Surgery, Brigham and Women’s Hospital, Harvard Medical School, 45 Francis St, ASB II-3, Boston, MA, 02115, USA

    Quoc-Dien Trinh

Authors
  1. Daniel Pucheril
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  2. Sean A. Fletcher
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  9. Adam S. Kibel
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  11. Quoc-Dien Trinh
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Corresponding author

Correspondence to Quoc-Dien Trinh.

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Disclosures

This study was funded by Intuitive Surgical Inc., which had no involvement in the conduction or reporting of this study. Dr. Quoc-Dien Trinh reports personal fees from Astellas, Bayer and Janssen, outside the submitted work. Dr. Adam S. Kibel reports personal fees from Pfizer, Blue Earth, Merck, Insightec, Profound and Janssen, outside the submitted work. Dr. Daniel Pucheril, Dr. Sean A. Fletcher, Ms. Xi Chen, Dr. David F. Friedlander, Dr. Alexander P. Cole, Dr. Marieke Krimphove, Dr. Adam C. Fields, Dr. Nelya Melnitchouk, and Dr. Prokar Dasgupta have no conflicts of interests or financial ties to disclose.

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Pucheril, D., Fletcher, S.A., Chen, X. et al. Workplace absenteeism amongst patients undergoing open vs. robotic radical prostatectomy, hysterectomy, and partial colectomy. Surg Endosc 35, 1644–1650 (2021). https://doi.org/10.1007/s00464-020-07547-y

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  • DOI: https://doi.org/10.1007/s00464-020-07547-y

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