ArticleSurgical endoscopy2022
Robot-assisted pancreatoduodenectomy with the da Vinci Xi: can the costs of advanced technology be offset by clinical advantages? A case-matched cost analysis versus open approach.
Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Emerging multi-port soft tissue robotic systems: a systematic review of clinical outcomes.Journal of robotic surgery · 2024Pooled it
- Enhancing the Workflow of Full Robotic Pancreatoduodenectomy: A Counterclockwise Step-by-Step Approach to Resection and Reconstruction.Annals of surgical oncology · 2026Article
- Cost-analysis of Implementing Robot-assisted Versus Open Pancreatoduodenectomy.Annals of surgery · 2026Article
- Single-institution experience of 500 consecutive pancreatoduodenectomies: case-matched outcomes of the da Vinci Xi robotic versus open procedures.Surgical endoscopy · 2026Article
- Robotic portomesenteric vein reconstruction using self-fashioned bovine pericardial grafts during Da Vinci-assisted pancreatectomy: a case series with video demonstration.Surgical endoscopy · 2026Article
- The Current Landscape of Robotics in Lymphatic Supermicrosurgery: A Systematic Review.Archives of plastic surgery · 2026Article
- Barbed sutures for hepaticojejunostomy in robotic pancreatoduodenectomy: a case-matched analysis.Surgical endoscopy · 2026Article
- Clinical efficacy of enhanced recovery surgery in Da Vinci robot-assisted pancreatoduodenectomy.Scientific reports · 2024Article
- International consensus guidelines on robotic pancreatic surgery in 2023.Hepatobiliary surgery and nutrition · 2024Review
- Initial 50 consecutive full-robotic pancreatoduodenectomies without conversion by a single surgeon: a learning curve analysis from a tertiary referral high-volume center.Surgical endoscopy · 2023Article
- Features and applications of energy devices for prone robot-assisted minimally invasive esophagectomy: a narrative review.Journal of thoracic disease · 2022Review
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRobot-assisted pancreatoduodenectomy (RPD) has shown some advantages over open pancreatoduodenectomy (OPD) but few studies have reported a cost analysis between the two techniques. We conducted a structured cost-analysis comparing pancreatoduodenectomy performed with the use of the da Vinci Xi, and the traditional open approach, and considering healthcare direct costs associated with the intervention and the short-term post-operative course. MATERIALS AND
methodsTwenty RPD and 194 OPD performed between January 2011 and December 2020 by the same operator at our high-volume multidisciplinary center for robot-assisted surgery and for pancreatic surgery, were retrospectively analyzed. Two comparable groups of 20 patients (Xi-RPD-group) and 40 patients (OPD-group) were obtained matching 1:2 the RPD-group with the OPD-group. Perioperative data and overall costs, including overall variable costs (OVCs) and fixed costs, were compared.
resultsNo difference was reported in mean operative time: 428 min for Xi-RPD-group versus 404 min for OPD, p = 0.212. The median overall length of hospital stay was significantly lower in the Xi-RPD-group: 10 days versus 16 days, p = 0.001. In the Xi-RPD-group, consumable costs were significantly higher (€6149.2 versus €1267.4, p < 0.001), while hospital stay costs were significantly lower: €5231.6 versus €8180 (p = 0.001). No significant differences were found in terms of OVCs: €13,483.4 in Xi-RPD-group versus €11,879.8 in OPD-group (p = 0.076).
conclusionsRobot-assisted surgery is more expensive because of higher acquisition and maintenance costs. However, although RPD is associated to higher material costs, the advantages of the robotic system associated to lower hospital stay costs and the absence of difference in terms of personnel costs thanks to the similar operative time with respect to OPD, make the OVCs of the two techniques no longer different. Hence, the higher costs of advanced technology can be partially compensated by clinical advantages, particularly within a high-volume multidisciplinary center for both robot-assisted and pancreatic surgery. These preliminary data need confirmation by further studies.
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