Robotic-assisted general surgery was associated with a lower mortality rate (0.097%) compared to laparoscopic (0.48%) and open (0.92%) surgery (P<0.001).
Observational (n=1,426,505)
Yes
Does robotic-assisted general surgery reduce complications, mortality, length of stay, and costs compared to nonrobotic surgery in patients undergoing general surgery procedures?
Robotic general surgery appears to be cost-effective and safe compared to nonrobotic surgery, with shorter lengths of stay and lower overall mortality, though complication rates vary by specific procedure type.
p-value: p=<0.001
Since its introduction in 1997, robotic surgery has overcome many limitations, including setup costs and surgeon training. The use of robotics in general surgery remains unknown. This study evaluates robotic-assisted procedures in general surgery by comparing characteristics with its nonrobotic (laparoscopic and open) counterparts. Weighted Healthcare Cost and Utilization Project Nationwide Inpatient Sample data (2008, 2009) were used to identify the top 12 procedures for robotic general surgery. Robotic cases were identified by Current Procedural Terminology codes 17. 41 and 17. 42. Procedures were grouped: esophagogastric, colorectal, adrenalectomy, lysis of adhesion, and cholecystectomy. Analyses were descriptive, t tests, χ (2) s, and logistic regression. Charges and length of stay were adjusted for gender, age, race, payer, hospital bed size, hospital location, hospital region, median household income, Charlson score, and procedure type. There were 1, 389, 235 (97. 4%) nonrobotic and 37, 270 (2. 6%) robotic cases. Robotic cases increased from 0. 8 per cent (2008) to 4. 3 per cent (2009, P < 0. 001). In all subgroups, robotic surgery had significantly shorter lengths of stay (4. 9 days) than open surgery (6. 1 days) and lower charges (median 30, 540) than laparoscopic (34, 537) and open (46, 704) surgery. Fewer complications were seen in robotic-assisted colorectal, adrenalectomy and lysis of adhesion; however, robotic cholecystectomy and esophagogastric procedures had higher complications than nonrobotic surgery (P < 0. 05). Overall robotic surgery had a lower mortality rate (0. 097%) than nonrobotic surgeries per 10, 000 procedures (laparoscopic 0. 48%, open 0. 92%; P < 0. 001). The cost of robotic surgery is generally considered a prohibitive factor. In the present study, when overall cost was considered, including length of stay, robotic surgery appeared to be cost-effective and as safe as nonrobotic surgery except in cholecystectomy and esophagogastric procedures. Further study is needed to fully understand the long-term implications of this new technology.
Salman et al. (Sat,) conducted a observational in General surgery procedures (n=1,426,505). Robotic-assisted general surgery vs. Nonrobotic (laparoscopic and open) general surgery was evaluated on Mortality rate (p=<0.001). Robotic-assisted general surgery was associated with a lower mortality rate (0.097%) compared to laparoscopic (0.48%) and open (0.92%) surgery (P<0.001).