Evidence map›Paper›PMID 35939166›Full record

ArticleJournal of robotic surgery2023

Cost analysis of robotic assisted general surgery cases in a single academic institution.

Eva Munshower, Emily Ren, Wayne B Bauerle, Janice Ruland, Jill Stoltzfus, Marian McDonald, Daniel R Baillie, Maher El Chaar

Abstract read
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In one paragraph

Article in Journal of robotic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Robotic versus Laparoscopic Hiatal Hernia Repair in Elderly Patients.JSLS : Journal of the Society of Laparoendoscopic Surgeons
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Eva MunshowerTemple/St. Luke's School of Medicine, Bethlehem, PA, USA.
Emily RenTemple/St. Luke's School of Medicine, Bethlehem, PA, USA.
Wayne B BauerleDepartment of Research and Innovation, St. Luke's University Health Network, Bethlehem, PA, USA.
Janice RulandCost Accounting Department, St. Luke's University Health Network, Bethlehem, PA, USA.
Jill StoltzfusDepartment of Research and Innovation, St. Luke's University Health Network, Bethlehem, PA, USA.
Marian McDonaldDepartment of Surgery, Division of Minimally Invasive Surgery, St. Luke's University Hospital and Health Network, Allentown, PA, USA.
Daniel R BaillieDepartment of Surgery, Division of Minimally Invasive Surgery, St. Luke's University Hospital and Health Network, Allentown, PA, USA.
Maher El ChaarDepartment of Surgery, Division of Bariatric Surgery, St. Luke's University Hospital and Health Network, Allentown, PA, USA. Maher.Elchaar@sluhn.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Laparoscopy is currently the standard approach for minimally invasive general surgery procedures. However, robotic surgery is now increasingly being used in general surgery. Robotic surgery provides several advantages such as 3D-visualization, articulated instruments, improved ergonomics, and increased dexterity, but is also associated with an increased overall cost which limits its widespread use. In our institution, the robotic assisted approach is frequently used for the performance of general surgery cases including inguinal hernias, cholecystectomies and paraesophageal hernia (PEH) repairs. The primary aim of the study was to evaluate the differences in cost between a robotic and laparoscopic approach for the above-mentioned cases. With IRB approval, we conducted a retrospective cost analysis of patients undergoing inguinal hernia repairs, cholecystectomies and PEH repairs between June 2018 and November 2020. Patients who had a concomitant procedure, a revisional surgery, or bilateral inguinal hernia repair were excluded from the study. Cost analysis was performed using a micro-costing approach. Statistical significance was denoted by p < 0.05. There were no differences among the different groups in relation to age, gender, ethnicity, and BMI. The overall cost of the robotic (R-) approach compared to a laparoscopic (L-) approach was significantly lower for cholecystectomy ($3,199.96 vs $4019.89, p < 0.05). For inguinal hernia repairs and PEH repairs without mesh, we found no significant difference in overall costs between the R- and L- approach (R- $3835.06 vs L- $3783.50, p = 0.69) and (R- $6852.41 vs L- $6819.69, p = 0.97), respectively. However, the overall cost of PEH with mesh was significantly higher for the R- group compared to the L- group (R- $7,511.09 vs L- $6,443.32, p < 0.05). Based on our institutional cost data, use of a robotic approach when performing certain general surgery cases does not seem to be cost prohibitive.

Indexed as

Hernia, HiatalHernia, InguinalLaparoscopyRobotic Surgical ProceduresCosts and Cost AnalysisHerniorrhaphyHumansRetrospective StudiesCholecystectomyCostInguinal hernia repairParaesophageal hernia repairRobotic surgery

Identifiers

PMID35939166

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.