R Albrecht1, D Haase2, R Zippel2, H Koch3, U Settmacher4. 1. Klinik für Allgemein‑, Viszeral- und Minimal-invasive Chirurgie, HELIOS Klinikum Aue, Gartenstr. 6, 08280, Aue, Deutschland. roland.albrecht@helios-kliniken.de. 2. Klinik für Allgemein‑, Viszeral- und Gefäßchirurgie, ELBLANDKLINIKEN Riesa, Riesa, Deutschland. 3. Klinik für Psychiatrie und Psychotherapie, Heinrich Braun Krankenhaus Zwickau, Zwickau, Deutschland. 4. Klinik für Allgemein‑, Viszeral- und Gefäßchirurgie, Friedrich-Schiller-Universität Jena, Jena, Deutschland.
Abstract
AIM AND METHODS: By means of a matched-pair analysis comparing data obtained from laparoscopic cholecystectomy (LC) and robot-assisted laparoscopic cholecystectomy (RAC), the value of both methods as well as the advantages and disadvantages of both approaches were elucidated. The consideration was carried out by evaluation of postoperative surgical results, a cost analysis and a subjective survey of the patients using a questionnaire. Thus, from the 35 consecutive RAC, 35 (parallel) retrospectively matched pairs were established. RESULTS: Postoperative surgical results did not show any significant differences between LC and RAC. In the individual assessment by each patient, there were also no significant differences; however, there was a tendency towards the assessment of the RAC to be slightly worse. A striking difference was found with respect to the cost analysis at the time of surgery. CONCLUSION: The RAC operation alone is significantly more expensive compared to LC with respect to maintenance and acquisition costs. In addition, RAC can at present not be completely reimbursed under the current German diagnosis-related system. The postulated advantages of RAC comprise mainly the precise preparation within narrow confinements and the favorable ergonomic handling for the surgeon. The basic prerequisites are control of the costs and a reasonable reflection in the current reimbursement system.
AIM AND METHODS: By means of a matched-pair analysis comparing data obtained from laparoscopic cholecystectomy (LC) and robot-assisted laparoscopic cholecystectomy (RAC), the value of both methods as well as the advantages and disadvantages of both approaches were elucidated. The consideration was carried out by evaluation of postoperative surgical results, a cost analysis and a subjective survey of the patients using a questionnaire. Thus, from the 35 consecutive RAC, 35 (parallel) retrospectively matched pairs were established. RESULTS: Postoperative surgical results did not show any significant differences between LC and RAC. In the individual assessment by each patient, there were also no significant differences; however, there was a tendency towards the assessment of the RAC to be slightly worse. A striking difference was found with respect to the cost analysis at the time of surgery. CONCLUSION: The RAC operation alone is significantly more expensive compared to LC with respect to maintenance and acquisition costs. In addition, RAC can at present not be completely reimbursed under the current German diagnosis-related system. The postulated advantages of RAC comprise mainly the precise preparation within narrow confinements and the favorable ergonomic handling for the surgeon. The basic prerequisites are control of the costs and a reasonable reflection in the current reimbursement system.
Authors: Amir Szold; Roberto Bergamaschi; Ivo Broeders; Jenny Dankelman; Antonello Forgione; Thomas Langø; Andreas Melzer; Yoav Mintz; Salvador Morales-Conde; Michael Rhodes; Richard Satava; Chung-Ngai Tang; Ramon Vilallonga Journal: Surg Endosc Date: 2014-11-08 Impact factor: 4.584
Authors: Jason D Wright; Cande V Ananth; Sharyn N Lewin; William M Burke; Yu-Shiang Lu; Alfred I Neugut; Thomas J Herzog; Dawn L Hershman Journal: JAMA Date: 2013-02-20 Impact factor: 56.272