Technical modifications for cost optimization in robot-assisted ventral mesh rectopexy: an initial experience.
Tech Coloproctol
; 27(7): 551-557, 2023 07.
Article
in En
| MEDLINE
| ID: mdl-36802041
ABSTRACT
BACKGROUND:
Robot-assisted ventral mesh rectopexy is considered a valid option in the treatment of rectal prolapse. However, it involves higher costs than the laparoscopic approach. The aim of this study is to determine if less expensive robotic surgery for rectal prolapse can be safely performed.METHODS:
This study was conducted on consecutive patients who underwent robot-assisted ventral mesh rectopexy at Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, from 7 November 2020 to 22 November 2021. The cost of hospitalization, surgical procedure, robotic materials, and operating room resources in patients undergoing robot-assisted ventral mesh rectopexy with the da Vinci Xi Surgical Systems was analyzed before and after technical modifications, including the reduction of robotic arms and instruments, and the execution of a double minimal peritoneal incision at the pouch of Douglas and sacral promontory (instead of the traditional inverted J incision).RESULTS:
Twenty-two robot-assisted ventral mesh rectopexies were performed [21 females, 95.5%, median age 62.0 (54.8-70.0) years]. After an initial experience performing traditional robot-assisted ventral mesh rectopexy in four patients, we adopted technical modifications in other cases. No major complication or conversion to open surgery occurred. In total, mean cost of hospitalization, surgical procedure, robotic materials, and operating room resources was 6995.5 ± 1058.0, 5912.7 ± 877.0, 2797.6 ± 545.6, and 2608.3 ± 351.5, respectively. Technical modifications allowed a significant reduction in the overall cost of hospitalization (6604.5 ± 589.5 versus 8755.0 ± 906.4, p = 0.001), number of robotic instruments (3.1 ± 0.2 versus 4.0 ± 0.8 units, p = 0.026), and operating room time (201 ± 26 versus 253 ± 16 min, p = 0.003).CONCLUSIONS:
Considering our preliminary results, robot-assisted ventral mesh rectopexy with appropriate technical modifications can be cost-effective and safe.Key words
Full text:
1
Collection:
01-internacional
Health context:
1_ASSA2030
Database:
MEDLINE
Main subject:
Robotics
/
Rectal Prolapse
/
Laparoscopy
/
Robotic Surgical Procedures
Type of study:
Health_economic_evaluation
Limits:
Female
/
Humans
/
Middle aged
Language:
En
Journal:
Tech Coloproctol
Year:
2023
Document type:
Article