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Index cost comparison of laparoscopic vs robotic surgery in colon and rectal cancer resection: a retrospective financial investigation of surgical methodology innovation at a single institution

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A Correction to this article was published on 03 November 2022

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Abstract

Background

Robotic assisted colorectal cancer resection (R-CR) has become increasingly commonplace in contrast to traditional laparoscopic cancer resection (L-CR). The aim of this study was to compare the total direct costs of R-CR to that of L-CR and to compare the groups with respect to costs related to LOS.

Methods

Patients who underwent colon and/or rectal cancer resection via R-CR or L-CR instrumentation between January 1, 2015 and December 31 2018, at our institution, were evaluated and compared. Primary outcomes were overall cost, supply cost, operating time and cost, postoperative length of stay (LOS), and postoperative LOS cost. Secondary outcomes were readmission within 30 days and mortality during the surgery.

Results

Two hundred forty R-CR (mean age 64.9 ± 12.4 years) and 258 L-CR (mean age 66.4 ± 15.5 years) patients met the inclusion criteria. The overall mean direct cost between R-CR and L-CR was significantly higher ($8756 vs $7776 respectively, p=0.001) as well as the supply cost per case ($3789 vs $2122, p < 0.001). Operating time was also higher for R-CR than L-CR (224 min vs 187 min, p = 0.066) but LOS was slightly lower (5.08 days vs 5.55 days, p = 0.113).

Conclusions

Cost is the main obstacle to easy and widespread use of the platform at this junction, though new developments and competition could very well reduce costs. Supply cost was the main reason for increased costs with robotic resection.

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Acknowledgements

We would like to thank Pamela Bucki, Jason Hafron MD, Samer Kawak MD, and Michelle Jankowski for assistance with data acquisition and statistical analysis.

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The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Oakland University William Beaumont School of Medicine, 586 Pioneer Dr., Rochester, MI, 48309, USA

    E. U. Ezeokoli

  2. Department of Colorectal Surgery, Beaumont Health Systems, Royal Oak, MI, USA

    R. Hilli & H. J. Wasvary

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  1. E. U. Ezeokoli
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Correspondence to E. U. Ezeokoli.

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The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical and Informed Consent statement

After institutional review board approval and in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards, a prospectively maintained database at Royal Oak, William Beaumont Hospital was retrospectively queried to identify patients who underwent colon or rectal cancer resection between January 1, 2015 and. December 31, 2018.

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Ezeokoli, E.U., Hilli, R. & Wasvary, H.J. Index cost comparison of laparoscopic vs robotic surgery in colon and rectal cancer resection: a retrospective financial investigation of surgical methodology innovation at a single institution. Tech Coloproctol 27, 63–68 (2023). https://doi.org/10.1007/s10151-022-02703-z

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