Robotic versus laparoscopic cholecystectomy inpatient analysis: does the end justify the means?

Abstract

Background and objectives: Robotic-assisted cholecystectomy (RAC) was introduced several years ago. With its more extensive use by surgeons, more information is needed regarding clinical and economic outcomes.

Methods: The Nationwide Inpatient Sample from the Health Cost Utilization Project was analyzed using HCUPnet, National Inpatient Sample (NIS) datasets and SAS 9.2 for the years 2010-2011. Queries were made for RAC and laparoscopic cholecystectomy (LC) procedures with a primary diagnosis of gallbladder disease. Overall charges, costs, number of chronic conditions, comorbidities, and length of stay were calculated.

Results: RAC was $7518, +54 % (p < 0.05), and $4044, +29 % (p < 0.05), more costly compared to LC in 2010 and 2011, respectively. Total costs for RAC decreased by 14.6 % (p = 0.27) between 2010 and 2011, even though RAC was still costlier than LC in 2011. There was no significant difference in the LOS between RAC and LC in either years. Patients undergoing RAC had an increased number of chronic conditions compared to patients undergoing LC in both 2010 and 2011.

Conclusion: LOS of RAC is similar to LC. Cost of RAC remains higher compared to LC although there was reduction in cost of RAC in 2011 versus 2010.