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Comparison of outcome and costs of robotic and laparoscopic right hemicolectomies

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Abstract

To compare the outcomes of patients undergoing right hemicolectomy using laparoscopic or robotic approaches and perform a cost analysis. Retrospective review of all patients undergoing elective laparoscopic and robotic right hemicolectomies at a public and private hospital in NSW/QLD from January 2015 to June 2018. Cost analysis was calculated using actual and estimated costs by the local health district. A total of 101 patients were identified. 59 (58%) had Robotic resection, of which 44 (75%) had an intra-corporeal anastomosis. There were no demographic or oncological differences between the two groups. The robotic group had a significantly earlier time to bowels opening (2 vs 4 days, p < 0.001) and shorter length of stay (3 vs 5 days, p < 0.001). The robotic group had a lower rate of ileus (2% vs 14%, p = 0.02) and complications (5% vs 33%, p = 0.006). The mean lymph node harvest was higher in the robotic group (18 vs 14, p = 0.001). The operative time was longer in the robotic group (110 vs 97 min, p = 0.021). The total instrument costs of robotic surgery were A$2565.37 compared with $1507.50 for laparoscopic surgery. The cost of bed days was A$1167.00/day. The average difference in cost of care was calculated as A$1276.13 and A$464.43 less in the robotic with intra-corporeal and extra-corporeal anastomosis, respectively. Patients have significantly faster return to bowel function and shorter length of stay after Robotic vs laparoscopic right hemicolectomy and experience fewer complications. This difference in length of stay may make robotic right hemicolectomies more cost effective.

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Data available upon request.

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Data analysed using SPSS.

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Authors and Affiliations

  1. Department of Colorectal Surgery, The Tweed Hospital, Powell St, Tweed Heads, NSW, 2485, Australia

    Nima Ahmadi, Isabella Mor & Ross Warner

  2. Department of Colorectal Surgery, John Flynn Private Hospital, Tugun, QLD, 4224, Australia

    Isabella Mor & Ross Warner

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  1. Nima Ahmadi
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Contributions

Study concept and design: NA, RWarner. Data acquisition: NA, RW. Analysis and interpretation of data: NA, RW. Drafting of manuscript: NA. Critical revision: NA, RW, IM.

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Correspondence to Ross Warner.

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Lead author RW is a proctor for Intuitive Surgical. NA, and IM declare that they have no conflict of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Ahmadi, N., Mor, I. & Warner, R. Comparison of outcome and costs of robotic and laparoscopic right hemicolectomies. J Robotic Surg 16, 429–436 (2022). https://doi.org/10.1007/s11701-021-01246-z

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