Medico-economic impact of onco-urological robot-assisted minimally invasive surgery in a high-volume centre.

Abstract

We lack data regarding the economic cost of robot-assisted surgical procedures in urology. We aimed to assess the medico-economic impact of onco-urological robot-assisted surgery. All patients who underwent robot-assisted radical prostatectomy (RARP) or robot-assisted partial nephrectomy (RAPN) in 2019 were included. Cost assessment included the costs of surgery, hospital stay, and complications. Global cost was calculated and compared with open and laparoscopic procedures. Overall, 126 (48%) RAPN and 135 (52%) RARP were included. Total cost per patient was 6857€ for RARP and 6034€ for RAPN. Costs of surgery, hospital stay, and complications represented 76.2%, 21.5%, and 2.3%, respectively, of the total cost per patient for RAPN, and 74.1%, 25.9%, and 0% for RARP. Compared to the open approach, RAPN was 6% cheaper and RARP was 10% more expensive per patient. Standard laparoscopic procedures were cheaper. Robotic procedures were associated with increased costs of surgical procedures, but with reduction in morbidity and hospital stay costs.