Observational studySurgical endoscopy2018
The cost of conversion in robotic and laparoscopic colorectal surgery.
Observational study in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Short-term surgical outcomes of robotic-assisted versus laparoscopic ileal pouch-anal anastomosis (IPAA): a systematic review and meta-analysis.Surgical endoscopy · 2026Pooled it
- Colorectal cancer treatment assisted by robotic platforms - a systematic review.Journal of robotic surgery · 2026Pooled it
- The risk of conversion in minimally invasive oncological abdominal surgery. Meta-analysis of randomized evidence comparing traditional laparoscopic versus robot-assisted techniques.Langenbeck's archives of surgery · 2021Pooled it
- Simultaneous Robot Assisted Colon and Liver Resection for Metastatic Colon Cancer.JSLS : Journal of the Society of Laparoendoscopic SurgeonsPooled it
- The Revolution in Surgery That Saves Millions of Lives.Journal of clinical medicine · 2026Review
- Surgical outcomes in diverticular disease: a comparative analysis of robotic and laparoscopic sigmoidectomy.Journal of robotic surgery · 2025Article
- Comprehensive revenue comparison of pure robotic vs. hybrid robotic surgery for sigmoid colon and rectosigmoid cancer.Surgery today · 2025Article
- Cost analysis of robot NICE procedure versus open, laparoscopic, and robotic colorectal surgery: is there an economic benefit to natural orifice resection?Surgical endoscopy · 2025Article
- Minimally invasive converted to open versus upfront open surgeries for rectal cancer: a retrospective cohort study.Surgical endoscopy · 2025Article
- Use of Robotic Surgery for the Management of Orbital Diseases: A Comprehensive Review.Medicina (Kaunas, Lithuania) · 2025Review
- Robotic Versus Laparoscopic Liver Resection: A Nationwide Propensity Score Matched Analysis.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Trends and outcomes in colorectal cancer surgery: a multicenter cross-sectional study of minimally invasive versus open techniques in Germany.Surgical endoscopy · 2024Article
- Feasibility, clinical outcomes, and learning curves of robotic-assisted colorectal cancer surgery in a high-volume district general hospital: a cohort study.Annals of medicine and surgery (2012) · 2024Article
- Costs of Robotic and Laparoscopic Bariatric Surgery: A Retrospective Propensity Score-matched Analysis.Obesity surgery · 2024Article
- Robot-assisted vs. laparoscopic right hemicolectomy in octogenarians and nonagenarians: an analysis of the US nationwide inpatient sample 2005-2018.Aging clinical and experimental research · 2024Observational
- Does the pre-conversion platform matter? A comparison of laparoscopic and robotic converted to open colectomies.Surgical endoscopy · 2024Article
- Surgical outcomes and cost analysis of a multi-specialty robotic-assisted surgery caseload in the Australian public health system.Journal of robotic surgery · 2023Article
- Robotic Surgery and Hospital Reimbursement.Seminars in plastic surgery · 2023Review
- Health-care expenditures are less for minimally invasive than open colectomy for colon cancer: A US commercial claims database analysis.Surgical endoscopy · 2023Article
- Preliminary robotic abdominal wall reconstruction experience: single-centre outcomes of the first 150 cases.Langenbeck's archives of surgery · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundConversion from minimally invasive to open colorectal surgery remains common and costly. Robotic colorectal surgery is associated with lower rates of conversion than laparoscopy, but institutions and payers remain concerned about equipment and implementation costs. Recognizing that reimbursement reform and bundled payments expand perspectives on cost to include the entire surgical episode, we evaluated the role of minimally invasive conversion in total payments.
methodsThis is an observational study from a linked data registry including clinical data from the Michigan Surgical Quality Collaborative and payment data from the Michigan Value Collaborative between July 2012 and April 2015. We evaluated colorectal resections initiated with open and minimally invasive approaches, and compared reported risk-adjusted and price-standardized 30-day episode payments and their components.
resultsWe identified 1061 open, 1604 laparoscopic, and 275 robotic colorectal resections. Adjusted episode payments were significantly higher for open operations than for minimally invasive procedures completed without conversion ($19,489 vs. $15,518, p < 0.001). The conversion rate was significantly higher with laparoscopic than robotic operations (15.1 vs. 7.6%, p < 0.001). Adjusted episode payments for minimally invasive operations converted to open were significantly higher than for those completed by minimally invasive approaches ($18,098 vs. $15,518, p < 0.001). Payments for operations completed robotically were greater than those completed laparoscopically ($16,949 vs. $15,250, p < 0.001), but the difference was substantially decreased when conversion to open cases was included ($16,939 vs. $15,699, p = 0.041).
conclusionEpisode payments for open colorectal surgery exceed both laparoscopic and robotic minimally invasive options. Conversion to open surgery significantly increases the payments associated with minimally invasive colorectal surgery. Because conversion rates in robotic colorectal operations are half of those in laparoscopy, the excess expenditures attributable to robotics are attenuated by consideration of the cost of conversions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.