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The downtrending cost of robotic bariatric surgery: a cost analysis of 47,788 bariatric patients

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Abstract

The surgical robot is assumed to be a fixed, indirect cost. We hypothesized rising volume of robotic bariatric procedures would decrease cost per patient over time. Patients who underwent elective, initial gastric bypass (GB) or sleeve gastrectomy (SG) for morbid obesity were selected from Florida Agency for Health Care Administration database from 2017 to 2021. Inflation-adjusted cost per patient was collected. Cost-over-time ($/patient year) and change in cost-over-time were calculated for open, laparoscopic, and robotic cases. Linear regression on cost generated predictive parameters. Density plots utilizing area under the curve demonstrated cost overlap. Among 76 hospitals, 11,472 bypasses (223 open, 6885 laparoscopic, 4364 robotic) and 36,316 sleeves (26,596 laparoscopic, 9724 robotic) were included. Total cost for robotic was approximately 1.5-fold higher (p < 0.001) than laparoscopic for both procedures. For GB, laparoscopic had lower total ($15,520) and operative ($6497) average cost compared to open (total $17,779; operative $9273) and robotic (total $21,756; operative $10,896). For SG, laparoscopic total cost was significantly less than robotic ($10,691 vs. $16,393). Robotic GB cost-over-time increased until 2021, when there was a large decrease in cost (−$944, compared with 2020). Robotic SG total cost-over time fluctuated, but decreased significantly in 2021 (−$490 compared with 2020). While surgical costs rose significantly in 2020 for bariatric procedures, our study suggests a possible downward trend in robotic bariatric surgery as total and operative costs are decreasing at a higher rate than laparoscopic costs.

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Data for the study is available upon request.

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Authors and Affiliations

  1. Department of Surgery, University of South Florida Morsani College of Medicine, 2 Tampa General Circle, Rm 7015, Tampa, FL, 33606, USA

    Meagan D. Read, Johnathan Torikashvili, Haroon Janjua, Emily A. Grimsley, Paul C. Kuo & Salvatore Docimo

  2. Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA

    Meagan D. Read

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Contributions

MR, JT, PK, SD: Reviewed and wrote the manuscript HJ and EG and MR: Performed the statistically analysis All authors reviewed the manuscript.

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Correspondence to Salvatore Docimo.

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Conflict of interest

Dr. Meagan Read, Mr. Johnathan Torikashvili, Mr. Haroon Janjua, Dr. Emily Grimsley, Dr. Ricardo Pietrobon, and Dr. Paul Kuo have no conflicts of interest to disclose. Dr. Salvatore Docimo reports peaker Fees and Honorarium from Boston Scientific, BD, and Medtronic.

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Read, M.D., Torikashvili, J., Janjua, H. et al. The downtrending cost of robotic bariatric surgery: a cost analysis of 47,788 bariatric patients. J Robotic Surg 18, 63 (2024). https://doi.org/10.1007/s11701-023-01809-2

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