Louis Lenfant1, Guilherme Sawczyn2, Soodong Kim2, Alireza Aminsharifi3, Jihad Kaouk4. 1. Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Sorbonne University, GRC n°5, PREDICTIVE ONCO-UROLOGY, AP-HP, Hôpital Pitié-Salpêtrière, Urology, F-75013 PARIS, France. 2. Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA. 3. Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Urology, Shiraz University of MedicalSciences, Shiraz, Iran. 4. Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: kaoukj@ccf.org.
Abstract
BACKGROUND: In the era of efficient value-based health care, each surgical innovation should be proven to be cost-effective for the patient and the hospital administration. OBJECTIVE: To compare the costs associated with robot-assisted prostatectomy using a single-port (SP) or multiport (MP) robotic platform. DESIGN, SETTING, AND PARTICIPANTS: Costs for surgical care for consecutive patients with localized prostate cancer treated from November 2018 to November 2019 were itemized and evaluated. INTERVENTION: Patients were treated using either the SP (n = 78) or MP (n = 97) platform. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Demographics, perioperative data, and costs for surgical care of patients in both groups were analyzed. RESULTS AND LIMITATION: The mean cost for prostatectomy was comparable between SP ($13 512 ± $1615) and MP ($13 284 ± $1360; p = 0.32). The main cost differences between the groups were the cost of hospitalization, which was lower in the SP group (p < 0.001), offset by the cost of disposables in the operating room, which was higher in the SP group (p < 0.001). The mean length of stay was significantly shorter in the SP group (9.84 ± 11.3 vs 35.5 ± 29.1 h; p < 0.001) and the proportion of patients discharged home on the day of surgery was higher in the SP group (70% vs 5%; p < 0.001). The main limitation of this study is its retrospective design. CONCLUSIONS: Overall, the costs for SP and MP prostatectomy are comparable. The higher SP cost for consumable surgical materials is offset by the lower cost associated with hospitalization, which was largely due to a shorter hospital stay after SP surgery. PATIENT SUMMARY: In this report, we found that implementation of the new single-port robotic platform for radical prostatectomy was not associated with higher surgical care costs compared to conventional multiport surgery.
BACKGROUND: In the era of efficient value-based health care, each surgical innovation should be proven to be cost-effective for the patient and the hospital administration. OBJECTIVE: To compare the costs associated with robot-assisted prostatectomy using a single-port (SP) or multiport (MP) robotic platform. DESIGN, SETTING, AND PARTICIPANTS: Costs for surgical care for consecutive patients with localized prostate cancer treated from November 2018 to November 2019 were itemized and evaluated. INTERVENTION: Patients were treated using either the SP (n = 78) or MP (n = 97) platform. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Demographics, perioperative data, and costs for surgical care of patients in both groups were analyzed. RESULTS AND LIMITATION: The mean cost for prostatectomy was comparable between SP ($13 512 ± $1615) and MP ($13 284 ± $1360; p = 0.32). The main cost differences between the groups were the cost of hospitalization, which was lower in the SP group (p < 0.001), offset by the cost of disposables in the operating room, which was higher in the SP group (p < 0.001). The mean length of stay was significantly shorter in the SP group (9.84 ± 11.3 vs 35.5 ± 29.1 h; p < 0.001) and the proportion of patients discharged home on the day of surgery was higher in the SP group (70% vs 5%; p < 0.001). The main limitation of this study is its retrospective design. CONCLUSIONS: Overall, the costs for SP and MP prostatectomy are comparable. The higher SP cost for consumable surgical materials is offset by the lower cost associated with hospitalization, which was largely due to a shorter hospital stay after SP surgery. PATIENT SUMMARY: In this report, we found that implementation of the new single-port robotic platform for radical prostatectomy was not associated with higher surgical care costs compared to conventional multiport surgery.