A comparative single-center study comparing laparoscopic and robotic pancreas resection: clinical outcomes and costs analysis

Abstract

Background: The robotic surgery cost presents a critical issue which has not been well addressed yet. This study aims to compare the clinical outcomes and cost differences of robotic distal pancreatectomy (RDP) versus laparoscopic distal pancreatectomy (LDP). Methods: A database of laparoscopic and robotic pancreatic surgeries has been developed, and data have been prospectively recorded from October 2011 up to May 2017. An independent company performed the financial analysis. The study was approved by the institutional review board. All consecutive cases were conducted by the same group of surgeons who all possess a high degree of experience in both the laparoscopic and robotic approaches. Results: A total of 28 RDP and 26 LDP were included. The mean operative time was significantly lower in the LDP (294 vs 241 min; p = 0.02). The main intra and post-operative data were similar, except for the conversion rate (RDP: 3.6% vs LDP: 19.2%; p = 0.04) and hospital stay (RDP: 8.9 vs LDP 13.1 days; p = 0.04). The mean total costs were similar in both groups (RDP: 9198.64 € vs LDP: 9399.74 €; p > 0.5). The overall rate of pancreatic leak was 10.7% in the RDP group and 15.4% in the LDP group (p > 0.5). Conclusions: RDP showed lower conversion rate and shorter hospital stay than LDP at the price of longer operative time. RDP is financially comparable to LDP.