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Surgical Endoscopy

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18-09-2023 | Vesicorenal Reflux

Cost-effectiveness analysis of robot-assisted laparoscopic surgery for complex pediatric surgical conditions

Authors: Jiangrui Huang, Zhong Huang, Hong Mei, Liying Rong, Yun Zhou, Jialing Guo, Li Wan, Yinhui Xu, Shaotao Tang

Published in: Surgical Endoscopy | Issue 11/2023

Abstract

Background

Robotics has been used safely and successfully in a variety of adult surgeries and is gradually gaining ground in pediatrics. While the benefits of robotic-assisted surgery in disease treatment are well recognized, its high cost has led to questions. To investigate whether robotic-assisted laparoscopic surgery (RALS) is cost-effective compared to conventional laparoscopic surgery (LS) in pediatric surgery, we attempted to construct a model to perform an analysis of these two surgical approaches using Python statistical analysis software.

Methods

We selected four common complex pediatric surgical conditions (choledochal cyst, Hirschsprung's disease, vesicoureteral reflux, and congenital hydronephrosis) from three systems (pediatric hepatobiliary, gastroenterology, and urology). Models were constructed using Python statistical software to compare hospital costs and surgical outcomes for RALS and LS. In addition, we performed a preferred strategy analysis for both surgical modalities while assessing model uncertainty using one-way sensitivity analysis.

Results

For the four diseases, the operative time decreased sequentially. The total inpatient costs of RALS were 10,816.72, 9145.44, 8414.29, 7973.58 dollars, respectively, yielding 1.789, 1.712, 1.749, 1.792 quality adjustment life years (QALYs) over two years post-operatively. The incremental cost of RALS relative to LS for each disease was 3523.44, 3200.20, 3049.79, 3043.66 dollars, respectively, with an incremental utility of 0.060, 0.054, 0.051, 0.050 QALYs. The incremental cost-effectiveness ratios (ICERs) for RALS for each of the four diseases were 58,724.01, 59,262.95, 59,799.79, 60,873.20 dollars/QALY, all less than 100,000 dollars/QALY. The cost of robot consumables was the main incremental cost of RALS and had the most significant impact on the model.

Conclusion

For the four pediatric surgical conditions described above, RALS has higher inpatient costs than LS, but it has better postoperative outcomes, and all four RALS treatments are cost-effective. Children with complex diseases and long operative times appear to benefit more from RALS.

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Title: Cost-effectiveness analysis of robot-assisted laparoscopic surgery for complex pediatric surgical conditions
Authors: Jiangrui Huang
Zhong Huang
Hong Mei
Liying Rong
Yun Zhou
Jialing Guo
Li Wan
Yinhui Xu
Shaotao Tang
Publication date: 18-09-2023
Publisher: Springer US
Keyword: Vesicorenal Reflux
Published in: Surgical Endoscopy / Issue 11/2023
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10399-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cost-effectiveness analysis of robot-assisted laparoscopic surgery for complex pediatric surgical conditions

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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