A retrospective comparison of robotic cholecystectomy versus laparoscopic cholecystectomy: operative outcomes and cost analysis

David S. Strosberg, Michelle C. Nguyen, Peter Muscarella, Vimal K. Narula

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Introduction: Robotic-assisted surgery is gaining popularity in general surgery. Our objective was to evaluate and compare operative outcomes and total costs for robotic cholecystectomy (RC) and laparoscopic cholecystectomy (LC). Methods and Procedures: A retrospective review was performed for all patients who underwent single-procedure RC and LC from January 2011 to July 2015 by a single surgeon at a large academic medical center. Demographics, diagnosis, perioperative variables, postoperative complications, 30-day readmissions, and operative and hospital costs were collected and analyzed between those patient groups. Results: A total of 237 patients underwent RC or LC, and comprised the study population. Ninety-seven patients (40.9 %) underwent LC, and 140 patients (50.1 %) underwent RC. Patients who underwent RC had a higher body mass index (p = 0.03), lower rates of coronary artery disease (p < 0.01), and higher rates of chronic cholecystitis (p < 0.01). There were lower rates of intraoperative cholangiography (p < 0.01) and conversion to an open procedure (p < 0.01), however longer operative times (p < 0.01) for patients in the RC group. There were no bile duct injuries in either group, no difference in bile leak rates (p = 0.65), or need for reoperation (p = 1.000). Cost analysis of outpatient-only procedures, excluding cases with conversion to open or use of intraoperative cholangiography, demonstrated higher total charges (p < 0.01) and cost (p < 0.01) and lower revenue (p < 0.01) for RC compared to LC, with no difference in total payments (p = 0.34). Conclusions: Robotic cholecystectomy appears to be safe although costlier in comparison with laparoscopic cholecystectomy. Further studies are needed to understand the long-term implications of robotic technology, the cost to the health care system, and its role in minimally invasive surgery.

Original languageEnglish (US)
Pages (from-to)1436-1441
Number of pages6
JournalSurgical Endoscopy and Other Interventional Techniques
Volume31
Issue number3
DOIs
StatePublished - Mar 1 2017

Fingerprint

Laparoscopic Cholecystectomy
Robotics
Cholecystectomy
Costs and Cost Analysis
Cholangiography
Conversion to Open Surgery
Cholecystitis
Minimally Invasive Surgical Procedures
Hospital Costs
Operative Time
Bile Ducts
Reoperation
Bile
Coronary Artery Disease
Body Mass Index
Outpatients
Demography
Technology
Delivery of Health Care

Keywords

  • Cholecystectomy
  • Cost analysis
  • Laparoscopic surgery
  • Robotic surgery

ASJC Scopus subject areas

  • Surgery

Cite this

A retrospective comparison of robotic cholecystectomy versus laparoscopic cholecystectomy : operative outcomes and cost analysis. / Strosberg, David S.; Nguyen, Michelle C.; Muscarella, Peter; Narula, Vimal K.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 31, No. 3, 01.03.2017, p. 1436-1441.

Research output: Contribution to journalArticle

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