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- Title
Economic analysis of the robotic approach to inguinal hernia versus laparoscopic: is it sustainable for the healthcare system?
- Authors
Hinojosa-Ramirez, F.; Tallon-Aguilar, L.; Tinoco-Gonzalez, J.; Sanchez-Arteaga, A.; Aguilar-Del Castillo, F.; Alarcon-Del Agua, I.; Morales-Conde, S.
- Abstract
Introduction: There has been a rapid proliferation of the robotic approach to inguinal hernia, mainly in the United States, as it has shown similar outcomes to the laparoscopic approach but with a significant increase in associated costs. Our objective is to conduct a cost analysis in our setting (Spanish National Health System). Materials and methods: A retrospective single-center comparative study on inguinal hernia repair using a robotic approach versus laparoscopic approach. Results: A total of 98 patients who underwent either robotic or laparoscopic TAPP inguinal hernia repair between October 2021 and July 2023 were analyzed. Out of these 98 patients, 20 (20.4%) were treated with the robotic approach, while 78 (79.6%) underwent the laparoscopic approach. When comparing both approaches, no significant differences were found in terms of complications, recurrences, or readmissions. However, the robotic group exhibited a longer surgical time (86 ± 33.07 min vs. 40 ± 14.46 min, p < 0.001), an extended hospital stays (1.6 ± 0.503 days vs. 1.13 ± 0.727 days, p < 0.007), as well as higher procedural costs (2318.63 ± 205.15 € vs. 356.81 ± 110.14 €, p < 0.001) and total hospitalization costs (3272.48 ± 408.49 € vs. 1048.61 ± 460.06 €, p < 0.001). These results were consistent when performing subgroup analysis for unilateral and bilateral hernias. Conclusions: The benefits observed in terms of recurrence rates and post-surgical complications do not justify the additional costs incurred by the robotic approach to inguinal hernia within the national public healthcare system. Nevertheless, it represents a simpler way to initiate the robotic learning curve, justifying its use in a training context.
- Subjects
HERNIA surgery; SURGICAL complications; INGUINAL hernia; LEARNING curve; MEDICAL care costs
- Publication
Hernia, 2024, Vol 28, Issue 4, p1205
- ISSN
1265-4906
- Publication type
Article
- DOI
10.1007/s10029-024-03006-y