{"title":"机器人辅助脊柱手术的成本效益:单中心回顾性研究","authors":"Sorayouth Chumnanvej , Krish Ariyaprakai , Branesh M. Pillai , Jackrit Suthakorn , Sharvesh Gurusamy , Siriluk Chumnanvej","doi":"10.1016/j.lers.2023.11.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Robotic-assisted spine surgeries (RASS) have been shown to enhance precision, reduce operative time, prevent complications, facilitate minimally invasive spinal surgery, and decrease revision surgery rates, leading to improved patient outcomes. This study aimed to compare the cost-effectiveness of RASS and non-robotic-assisted surgery for degenerative spine disease at a single center.</p></div><div><h3>Methods</h3><p>This retrospective study, including 122 patients, was conducted at a single center from March 2015 to February 2022. Patients who underwent robot-assisted surgery were assigned to the robot group, and patients who underwent non-robotic-assisted surgery were assigned to the non-robot group. Various data, including demographic information, surgical details, outcomes, and cost-effectiveness, were collected for both groups. The cost-effectiveness was determined using the incremental cost-effectiveness ratio (ICER), and subgroup analysis was conducted for patients with 1 or 2 levels of spinal instrumentation. The analysis was performed using STATA SE version 15 and TreeAge Pro 2020, with Monte Carlo simulations for the cost-effectiveness acceptability curve.</p></div><div><h3>Results</h3><p>The overall ICER was $22,572, but it decreased to $16,980 when considering cases with only 1 or 2 levels of instrumentation. RASS is deemed cost-effective when the willingness to pay is $3000–$4000 if less than 2 levels of the spine are instrumented.</p></div><div><h3>Conclusions</h3><p>The cost-effectiveness of robotic assistance becomes apparent when there is a reduced need for open surgeries, leading to decreased revision rates caused by complications such as misplaced screws or infections. Therefore, it is advisable to allocate healthcare budget resources to spine robots, as RASS proves to be cost-effective, particularly when only two or fewer spinal levels require instrumentation.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"6 4","pages":"Pages 147-153"},"PeriodicalIF":0.0000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900923000646/pdfft?md5=ebcbb101d0bc0c1a36ee22aed7fb3459&pid=1-s2.0-S2468900923000646-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Cost-effectiveness of robotic-assisted spinal surgery: A single-center retrospective study\",\"authors\":\"Sorayouth Chumnanvej , Krish Ariyaprakai , Branesh M. Pillai , Jackrit Suthakorn , Sharvesh Gurusamy , Siriluk Chumnanvej\",\"doi\":\"10.1016/j.lers.2023.11.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>Robotic-assisted spine surgeries (RASS) have been shown to enhance precision, reduce operative time, prevent complications, facilitate minimally invasive spinal surgery, and decrease revision surgery rates, leading to improved patient outcomes. This study aimed to compare the cost-effectiveness of RASS and non-robotic-assisted surgery for degenerative spine disease at a single center.</p></div><div><h3>Methods</h3><p>This retrospective study, including 122 patients, was conducted at a single center from March 2015 to February 2022. Patients who underwent robot-assisted surgery were assigned to the robot group, and patients who underwent non-robotic-assisted surgery were assigned to the non-robot group. Various data, including demographic information, surgical details, outcomes, and cost-effectiveness, were collected for both groups. The cost-effectiveness was determined using the incremental cost-effectiveness ratio (ICER), and subgroup analysis was conducted for patients with 1 or 2 levels of spinal instrumentation. The analysis was performed using STATA SE version 15 and TreeAge Pro 2020, with Monte Carlo simulations for the cost-effectiveness acceptability curve.</p></div><div><h3>Results</h3><p>The overall ICER was $22,572, but it decreased to $16,980 when considering cases with only 1 or 2 levels of instrumentation. RASS is deemed cost-effective when the willingness to pay is $3000–$4000 if less than 2 levels of the spine are instrumented.</p></div><div><h3>Conclusions</h3><p>The cost-effectiveness of robotic assistance becomes apparent when there is a reduced need for open surgeries, leading to decreased revision rates caused by complications such as misplaced screws or infections. Therefore, it is advisable to allocate healthcare budget resources to spine robots, as RASS proves to be cost-effective, particularly when only two or fewer spinal levels require instrumentation.</p></div>\",\"PeriodicalId\":32893,\"journal\":{\"name\":\"Laparoscopic Endoscopic and Robotic Surgery\",\"volume\":\"6 4\",\"pages\":\"Pages 147-153\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2468900923000646/pdfft?md5=ebcbb101d0bc0c1a36ee22aed7fb3459&pid=1-s2.0-S2468900923000646-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laparoscopic Endoscopic and Robotic Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2468900923000646\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laparoscopic Endoscopic and Robotic Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468900923000646","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的机器人辅助脊柱手术(RASS)已被证明可提高精确度、缩短手术时间、预防并发症、促进微创脊柱手术并降低翻修手术率,从而改善患者预后。这项研究旨在比较单一中心的机器人辅助手术和非机器人辅助手术治疗退行性脊柱疾病的成本效益。方法这项回顾性研究于2015年3月至2022年2月在单一中心进行,共纳入122名患者。接受机器人辅助手术的患者被分配到机器人组,接受非机器人辅助手术的患者被分配到非机器人组。收集了两组患者的各种数据,包括人口统计学信息、手术细节、结果和成本效益。成本效益采用增量成本效益比(ICER)确定,并对脊柱器械植入1层或2层的患者进行了亚组分析。分析使用 STATA SE 15 版和 TreeAge Pro 2020 进行,并对成本效益可接受性曲线进行了蒙特卡罗模拟。结果总体 ICER 为 22,572 美元,但考虑到只有 1 或 2 层器械的病例,ICER 降至 16,980 美元。当脊柱器械植入少于 2 个层次时,当支付意愿为 3000 美元至 4000 美元时,RASS 被认为具有成本效益。因此,将医疗预算资源分配给脊柱机器人是明智之举,因为 RASS 被证明是具有成本效益的,尤其是当只有两个或更少的脊柱水平需要器械时。
Cost-effectiveness of robotic-assisted spinal surgery: A single-center retrospective study
Objective
Robotic-assisted spine surgeries (RASS) have been shown to enhance precision, reduce operative time, prevent complications, facilitate minimally invasive spinal surgery, and decrease revision surgery rates, leading to improved patient outcomes. This study aimed to compare the cost-effectiveness of RASS and non-robotic-assisted surgery for degenerative spine disease at a single center.
Methods
This retrospective study, including 122 patients, was conducted at a single center from March 2015 to February 2022. Patients who underwent robot-assisted surgery were assigned to the robot group, and patients who underwent non-robotic-assisted surgery were assigned to the non-robot group. Various data, including demographic information, surgical details, outcomes, and cost-effectiveness, were collected for both groups. The cost-effectiveness was determined using the incremental cost-effectiveness ratio (ICER), and subgroup analysis was conducted for patients with 1 or 2 levels of spinal instrumentation. The analysis was performed using STATA SE version 15 and TreeAge Pro 2020, with Monte Carlo simulations for the cost-effectiveness acceptability curve.
Results
The overall ICER was $22,572, but it decreased to $16,980 when considering cases with only 1 or 2 levels of instrumentation. RASS is deemed cost-effective when the willingness to pay is $3000–$4000 if less than 2 levels of the spine are instrumented.
Conclusions
The cost-effectiveness of robotic assistance becomes apparent when there is a reduced need for open surgeries, leading to decreased revision rates caused by complications such as misplaced screws or infections. Therefore, it is advisable to allocate healthcare budget resources to spine robots, as RASS proves to be cost-effective, particularly when only two or fewer spinal levels require instrumentation.
期刊介绍:
Laparoscopic, Endoscopic and Robotic Surgery aims to provide an academic exchange platform for minimally invasive surgery at an international level. We seek out and publish the excellent original articles, reviews and editorials as well as exciting new techniques to promote the academic development.
Topics of interests include, but are not limited to:
▪ Minimally invasive clinical research mainly in General Surgery, Thoracic Surgery, Urology, Neurosurgery, Gynecology & Obstetrics, Gastroenterology, Orthopedics, Colorectal Surgery, Otolaryngology, etc.;
▪ Basic research in minimally invasive surgery;
▪ Research of techniques and equipments in minimally invasive surgery, and application of laparoscopy, endoscopy, robot and medical imaging;
▪ Development of medical education in minimally invasive surgery.