Robotic-Assisted Treatment of Large Incisional Abdominal Wall Hernias: A Cost Analysis

Abstract

Abstract Background Robotic-assisted treatment of ventral hernia offers many advantages, however, studies reported higher costs for robotic surgery compared to other surgical techniques. Aims We aimed at comparing hospital costs in patients undergoing large ventral hernia repair with either robotic or open surgery. Methods We retrospectively searched from a prospectively maintained database patients who underwent robotic or open surgery for the treatment of the large ventral hernias from January 2016 to December 2022. The primary endpoint was to assess the costs incurred by the hospital in both groups. For eligible patients, data was extracted analyzed using a propensity score-matching. Results During the study period, 67 patients were retrieved from our database. 34 patients underwent robotic-assisted surgery while 33 underwent open surgery. Mean age was 66.4 years ±4.1 years, 50% of patients were male. After a propensity score-matching, a similar total cost of 18,297±8,435 EUR vs. 18,024±7,514, p=0.913 in robotic-assisted and open surgery groups were noted. Robotic surgery showed higher operatory theatre-related costs (7,532±2,091 EUR vs. 3,351±1,872 EUR, p<0.001), which were fully compensated by a shorter hospital stay of 5.3±4.5 vs. 10.4±5.2 days, p=0.002 (costs: 4,265±4,366 EUR vs. 7,373±4,698 EUR, p=0.032). Conclusion Our study showed that in the treatment of large ventral hernia, robotic surgery had higher operatory theatre-related costs, however, they were fully compensated by shorter hospital stays and resulting in similar total costs.