Robotic-assisted gastrectomy compared with open resection: a comparative study of clinical outcomes and cost-effectiveness analysis

J Robot Surg. 2020 Aug;14(4):627-632. doi: 10.1007/s11701-019-01033-x. Epub 2019 Oct 16.

Abstract

In the last decade, there have clearly been important changes in the surgical approach of gastric cancer treatment due to an increased interest in the minimally invasive surgical approach (MIS). The higher cost of robotic surgery procedures remains an important issue of debate. The objective of the study is to compare the main operative and clinical outcomes and to assess the incremental cost-effectiveness ratios (ICERs) of the two techniques. This is a prospective cost-effectiveness and clinical study when comparing the robotic gastrectomy (RG) technique with open gastrectomy (OG) in gastric cancer. Outcome parameters included surgical and post-operative costs, quality-adjusted life years (QALY) and incremental cost per QALY gained or the incremental cost-effectiveness ratio (ICER). The incremental utility was 0.038 QALYs and the estimated ICER for patients was dominated by robotic approach. The probability that the robotic approach was cost effective was 94.04% and 94.20%, respectively, at a WTP threshold of 20,000€ and 30,000€ per QALY gained. RG for gastric cancer represents a cost-effective procedure compared with the standard OG.

Keywords: Gastrectomy; Gastric cancer; Robotic surgery.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Cost-Benefit Analysis*
  • Female
  • Gastrectomy / economics*
  • Gastrectomy / methods*
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / economics*
  • Minimally Invasive Surgical Procedures / methods*
  • Prospective Studies
  • Quality-Adjusted Life Years
  • Robotic Surgical Procedures / economics*
  • Robotic Surgical Procedures / methods*
  • Stomach Neoplasms / surgery*
  • Treatment Outcome