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Cost analysis of robotic versus laparoscopic general surgery procedures

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Abstract

Background

Robotic surgical systems have been used at a rapidly increasing rate in general surgery. Many of these procedures have been performed laparoscopically for years. In a surgical encounter, a significant portion of the total costs is associated with consumable supplies. Our hospital system has invested in a software program that can track the costs of consumable surgical supplies. We sought to determine the differences in cost of consumables with elective laparoscopic and robotic procedures for our health care organization.

Methods

De-identified procedural cost and equipment utilization data were collected from the Surgical Profitability Compass Procedure Cost Manager System (The Advisory Board Company, Washington, DC) for our health care system for laparoscopic and robotic cholecystectomy, fundoplication, and inguinal hernia between the years 2013 and 2015. Outcomes were length of stay, case duration, and supply cost. Statistical analysis was performed using a t-test for continuous variables, and statistical significance was defined as p < 0.05.

Results

The total cost of consumable surgical supplies was significantly greater for all robotic procedures. Length of stay did not differ for fundoplication or cholecystectomy. Length of stay was greater for robotic inguinal hernia repair. Case duration was similar for cholecystectomy (84.3 robotic and 75.5 min laparoscopic, p = 0.08), but significantly longer for robotic fundoplication (197.2 robotic and 162.1 min laparoscopic, p = 0.01) and inguinal hernia repair (124.0 robotic and 84.4 min laparoscopic, p = ≪0.01).

Conclusions

We found a significantly increased cost of general surgery procedures for our health care system when cases commonly performed laparoscopically are instead performed robotically. Our analysis is limited by the fact that we only included costs associated with consumable surgical supplies. The initial acquisition cost (over $1 million for robotic surgical system), depreciation, and service contract for the robotic and laparoscopic systems were not included in this analysis.

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Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA

    Rana M. Higgins, Matthew J. Frelich, Matthew E. Bosler & Jon C. Gould

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  1. Rana M. Higgins
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  2. Matthew J. Frelich
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  3. Matthew E. Bosler
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  4. Jon C. Gould
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Correspondence to Jon C. Gould.

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Disclosures

Dr. Jon C Gould is a consultant for Torax Medical. Dr. Rana M Higgins, Matthew E Bosler, and Matthew J Frelich have no conflict of interest or financial ties to disclose.

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Higgins, R.M., Frelich, M.J., Bosler, M.E. et al. Cost analysis of robotic versus laparoscopic general surgery procedures. Surg Endosc 31, 185–192 (2017). https://doi.org/10.1007/s00464-016-4954-2

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  • DOI: https://doi.org/10.1007/s00464-016-4954-2

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