Despoina Daskalaki · Journal of Laparoendoscopic & Advanced Surgical Techniques 2017 · retrospective comparative cohort study · n=123

Financial Impact of the Robotic Approach in Liver Surgery: A Comparative Study of Clinical Outcomes and Costs Between the Robotic and Open Technique in a Single Institution

Cited 122 times in the scientific literature.

Level 3 - non-randomized controlled study

Non-randomized comparative cohort study

OpenAlex W2592910401 · doi:10.1089/lap.2016.0576 · record verified 2026-08-26

What was done

A single-center comparative cohort study compared 68 robotic and 55 open hepatectomies performed between January 2009 and December 2013. Demographics, perioperative data, postoperative outcomes, and economic parameters (direct variable, direct fixed, and indirect costs evaluated by an independent company) were analyzed.

What was found

Compared with the open approach, robotic hepatectomy resulted in: - Significantly lower mean estimated blood loss: 438 mL versus 727.8 mL (P = .038) - Significantly lower overall morbidity: 22% versus 40% (P = .047) - Significantly fewer Clavien III/IV complications: 4.4% versus 16.3% (P = .043) - Significantly shorter ICU length of stay: 2.1 versus 3.3 days (P = .004) - Average total cost including readmissions was $37,518 for robotic surgery versus $41,948 for open surgery (no P-value reported in abstract)

Why it matters

The findings indicate that clinical advantages of robotic liver resection—primarily fewer major complications and shorter ICU stays—can offset equipment costs, making total procedural costs comparable to open surgery.

Limits

Single-center retrospective design subject to selection bias in surgical approach assignment. The abstract does not provide statistical significance or confidence intervals for the cost comparison, nor details on resection extent or baseline disease severity.

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