IJSR - International Journal of Scientific Research

Dr Yatin Talwar

Volume : VI, Issue : VII, July - 2017

A Comparative Study Of Cost And Clinical Outcome Of RoboticAssisted Versus Conventional Surgeries In A Tertiary Care Hospital Of North India

Dr Yatin Talwar

Abstract :

Background and Objectives: Open and Laparoscopic urological surgeries, with and without robotic assistance, are performed to treat both benign and malignant disease. This study compared clinical and economic outcomes for conventional surgeries and surgeries with robotic assistance.

Methods: Patients aged above 18 years having need for primary inpatient urological procedures identified by ICD (International Classification of Diseases,) Ninth Edition procedure codes were studied. Patients were matched to a control cohort using propensity scores for disease, co morbidities, and hospital characteristics. The outcomes of interest were hospital cost of laparoscopic robotic–assisted surgery compared with traditional mode of surgeries, surgery time, adverse events, and length of stay.

Results: Of 1000 laparoscopic surgeries identified, 95% were performed without robotic assistance and 4% were performed with robotic assistance. After matching, 120 patients remained, 60 in each group. Lengths of stay were significantly different between the matched cohorts, but there was no significant difference in rates of major, minor, and/or surgical complications.

Inpatient procedures with robotic assistance were significantly more costly than those without robotic assistance Operative times were significantly longer for robotic–assisted procedures.

Conclusion The robotic procedures may have prolonged operative times and substantial cost burden, but the significantly reduced average length of stay gives it a winning edge over conventional surgeries. Though these studies are still in preliminary stages , hence further investigation is warranted when considering robotic technology for routine laparoscopic surgeries