Robotic surgery costs: Revealing the real villains
Yves Melo Rodrigues Martins, Pedro Romanelli de Castro, Ana Paula Drummond‐Lage, Alberto Julius Alves Wainstein, Fernando Augusto de Vasconcellos Santos
Abstract
BACKGROUND: This study aimed to evaluate the main drivers of robot assisted radical prostatectomy (RARP) hospitalization costs, in addition to assess perioperative predictors that impact costs. METHODS: Overall, 474 RARP were analyzed between February 2018 and December 2019. The association between perioperative variables and total direct costs was analyzed by simple and multiple linear regression. DISCUSSION: The main drivers of RARP hospitalization costs were robotic surgical supplies. Costs increased with American Society of Anesthesiologists score 3, a one-hour increase in OR time, increased utilization of polymeric clip packs and longer length of hospital stay. There was a 11.5% reduction in costs with the use of four robotic instruments instead of five. CONCLUSION: Costs of hospitalization were mainly influenced by the OR time, use of surgical supplies and length of hospital stay. Reducing the number of robotic instruments used in RARP represented the potentially modifiable factor with the greatest impact on cost reduction.