Cost Comparison of Robotic, Video-assisted Thoracic Surgery and Thoracotomy Approaches to Pulmonary Lobectomy
Section snippets
Materials and methods
Approval for the study was obtained and the need for individual patient consent was waived by the Institutional Review Board. The financial database (Decision Support System, Eclipsys Corporation, Atlanta, GA) of a single institution was queried retrospectively using CPT codes to identify all patients undergoing thoracotomy lobectomy (32480), VATS lobectomy (32663), and robotic VATS lobectomy (32663+99997) in the calendar year of 2007.
The type of surgical resection was determined by the
Results
From January 1, 2007, through December 31, 2007, 269 patients underwent thoracotomy lobectomy, and 99 patients underwent VATS lobectomy with 87 having VATS alone and 12 patients having a robotic-assisted procedure. The operating room times for each group were similar (thoracotomy: 3 hours, 43 minutes; VATS: 3 hours, 45 minutes; robotic: 3 hours, 37 minutes). The average length of stay of the thoracotomy group was 6 days versus 4 days for all VATS patients with no differences between length of
Comment
In this largest series of cases of lobectomy, by either thoracotomy or VATS (both robotic and nonrobotic), subjected to a cost analysis, we have shown that use of a minimally invasive VATS approach results in decreased cost of pulmonary lobectomy compared with standard thoracotomy. Taking into consideration real cost data that included all indirect, direct, and surgeon's fees, we demonstrated that patients undergoing thoracotomy incurred costs that were much higher than those undergoing VATS by
Acknowledgment
The authors acknowledge and thank Nicole M. Barrow, Donna Boccamazzo, and Suzanne Kelson from Memorial Sloan-Kettering Cancer Center's Clinical Systems and Hospital Administration who provided the financial data and analysis. We also thank Derek Goldstein and Intuitive Surgical for their input and support.
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