Comparison of hospital charges between robotic, laparoscopic stapled, and laparoscopic handsewn Roux-en-Y gastric bypass

The feasibility and safety of laparoscopic and robotic Roux-en-Y gastric bypass (RRYGB) have been established. To evaluate the cost-effectiveness of robotic surgery we compared the hospital charges for robotic, laparoscopic stapled (SRYGB), and laparoscopic handsewn Roux-en-Y gastric bypass (HRYGB) at our institution. One hundred thirty-five consecutive patients undergoing Roux-en-Y gastric bypass at Stanford University Medical Center by handsewn, stapled or robotic techniques from 1 July 2005 to 31 December 2005 were evaluated. Medical records of these patients were retrospectively reviewed and the following variables were collected and analyzed: age, gender, body mass index (BMI), number of preoperative comorbidities, length of stay (LOS), operating and anesthesia times, postoperative complications, mortality, professional fees, and hospital and total charges. Twenty-one RRYGB, 78 SRYGB, and 36 HRYGB were performed during the study period. Comparison of the above three groups demonstrated no statistically significant differences in age, gender, BMI, number of preoperative comorbidities, LOS, operating and anesthesia times, postoperative complications, mortality or professional fees. Total charges were higher for RRYGB (US $77,820) when compared with SRYGB (US $66,153) but not when compared with HRYGB (US $68,814). RRYGB higher hospital charges resulted in higher total charges when compared with SRYGB and HRYGB. These differences do not reflect actual cost to the hospital.