GI cancer

Robotic surgery costs more in time and money for colorectal cancer surgery

Robotic colorectal surgery procedures take twice as long, are more expensive and have longer hospital stays for the same outcomes compared to laparoscopic procedures, a Victorian study shows.

A retrospective study of 213 colorectal surgeries for cancer at a private Melbourne hospital found that procedures took more than twice as long (302 vs 130 minutes) in cases of robotic surgery compared to laparoscopic surgery.

Patients who underwent robotic surgery were more frequently admitted to ICU than those who had laparoscopic surgery (40 vs 17%) and also had longer length of stay in hospital ( 7 vs 5 days).

Outcomes and safety were similar for both techniques, with no significant differences in oncological resection margins, rates of open conversion, complications,  return to theatre or 30-day readmission rates.

However patients undergoing robotic surgery procedures faced additional consumable costs of $2728 as well as the extra costs for longer operative times and length of hospital stay, said the authors of the evaluation published in Australian Health Review.

The longer operative times with robotic surgery seemed to be unique to colorectal procedures, they commented, and other studies had suggested that the robotic platform might be better targeted to more complex or specific procedures.

Clinical benefits over laparoscopic procedures may become more apparent as robotic surgery technology advances and surgeons become more proficient, they suggested.

However given the steep learning curve and other drawbacks with robotic surgery such as lengthier procedure times and hospitals stays, it might be difficult to justify the use of a more expensive technique with no added benefit, they said.

In the meantime, “practitioners may counsel patients that robotic procedures are typically longer and more expensive, with a longer overall hospital admission and a higher likelihood of intensive care admission,” they wrote.

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