Pecuniary Inputs and their Applications to Intelligent Decision Making in Choice of Robotic and Conventional Surgeries in Gynecologic Oncology and Urology in A Private Sector Super Speciality Tertiary Care Hospital in Southern India.

Authors

  • Apoorva R. Nair Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of higher education, Manipal, Karnataka, India.
  • Sanjeev Chougule Assistant Professor, Department of Hospital Administration (MBA), JN Medical college, KAHER, KLE University, Belgaum, India
  • Isaac Raj Songa Manager – Healthcare operations, AIG hospitals, Hyderabad, Andhra Pradesh, India.
  • Vani Lakshmi R. Assistant Professor, Department of Data science, Prasanna school of public health, Manipal Academy of Higher Education, Manipal, Karnataka, India.
  • Sagarika Kamath Assistant Professor, Department of Commerce, Manipal Academy of Higher Education, Manipal, Karnataka, India.
  • Rajesh Kamath Assistant Professor – senior scale, Department of Social and Health Innovation, Prasanna school of public health, Manipal Academy of Higher Education, Manipal, Karnataka, India.
  • Reena Verma Corresponding author: Associate Professor, Department of Dietetics & Applied Nutrition, Welcomgroup Graduate School of Hotel Administration, Manipal academy of higher education, Manipal, India

Keywords:

Robotic surgery, Cost, Gynecologic oncology, Urology

Abstract

Introduction: Robotic surgery is highlighted as a new medical technology that has the ability to standardize surgical techniques and make minimally invasive surgery possible. It is particularly suitable for complex procedures that require a high level of precision. There is a lot of promise for future advancements in the field of robotic  surgery. The market for surgical robots was estimated at USD 4.4 billion globally in 2022, and it is anticipated to rise at a CAGR of 18 % from 2023 to 2030. This study involves the departments of gynecologic oncology and urology and intends to analyze the costs of both procedures- robotic surgery and traditional open surgery, in order to determine which procedure is more cost-effective.

Methods: This is a retrospective study carried out in a 1400 bedded private hospital in South India. A sample size of 249 was obtained from the departments of gynecologic oncology and urology. Medical records of the patients aged above 18 years who underwent robotic surgery and conventional open surgery were obtained and analysed.

Results: Out of the 249 patients, 55 patients were from Gynecologic oncology and 194 patients were from Urology. The Independent sample T test showed that the total cost for robotic surgery was significantly more (p-value<0.001) than the same for non-robotic surgery. The cost of medicines in robotic surgery was significantly more (p-value <0.001) than the same for non-robotic surgery. The cost of consumables for robotic surgery was significantly more (p-value <0.001) than the same for non-robotic surgery. The length of stay for robotic surgery was significantly more (p-value = 0.008) than the same for non-robotic surgery.

Discussion: The study shows that even if robotic surgery cost significantly more than conventional surgery, it is safer and the length of stay is lesser than for conventional surgery, which results in better bed utilization. Robotic surgery also has better clinical outcomes and lesser pain and complications.

Downloads

Download data is not yet available.

References

Morrell ALG, Morrell-Junior AC, Morrell AG, Mendes JMF, Tustumi F, De-Oliveira-e-silva LG, et al. The history of robotic surgery and its evolution: when illusion becomes reality. Rev Col Bras Cir [Internet]. 2021 [cited 2023 Apr 28];48:1–9. Available from: https://pubmed.ncbi.nlm.nih.gov/33470371/

George EI, Brand TC, LaPorta A, Marescaux J, Satava RM. Origins of Robotic Surgery: From Skepticism to Standard of Care. JSLS [Internet]. 2018 Oct 1 [cited 2023 Apr 28];22(4). Available from:

/pmc/articles/PMC6261744/

Kim YT, Kim SW, Jung YW. Robotic Surgery in Gynecologic Field. Yonsei Med J [Internet]. 2008 Dec 31 [cited 2023 Apr 28];49(6):886–90. Available from: https://doi.org/10.3349/ymj.2008.49.6.886

Secretariat MA. Robotic-Assisted Minimally Invasive Surgery for Gynecologic and Urologic Oncology: An Evidence-Based Analysis. Ont Health Technol Assess Ser [Internet]. 2010 [cited 2023 Apr 28];10(27):1. Available from: /pmc/articles/PMC3382308/

Leal Ghezzi T, Campos Corleta O. 30 Years of Robotic Surgery. World J Surg [Internet]. 2016 Oct 1 [cited 2023 Apr 28];40(10):2550–7. Available from: https://pubmed.ncbi.nlm.nih.gov/27177648/

Xue R, Liu R. Statistical analysis of da Vinci procedure volumes of 2021 in the Chinese Mainland. Intelligent Surgery. 2022 Sep 1;4:18–22.

Bora GS, Narain TA, Sharma AP, Mavuduru RS, Devana SK, Singh SK, et al. Robot-assisted surgery in India: A SWOT analysis. Indian J Urol [Internet]. 2020 Jan 1 [cited 2023 May 11];36(1):1. Available from: /pmc/articles/PMC6961426/

Tedesco G, Faggiano FC, Leo E, Derrico P, Ritrovato M. A comparative cost analysis of robotic-assisted surgery versus laparoscopic surgery and open surgery: the necessity of investing knowledgeably. SurgEndosc [Internet]. 2016 Nov 1 [cited 2023 May 28];30(11):5044–51. Available from: https://pubmed.ncbi.nlm.nih.gov/26983435/

Hyams E, Pierorazio P, Mullins JK, Ward M, Allaf M. A comparative cost analysis of robot-assisted versus traditional laparoscopic partial nephrectomy. J Endourol [Internet]. 2012 Jul 1 [cited 2023 May 28];26(7):843–7. Available from: https://pubmed.ncbi.nlm.nih.gov/22204599/

Ielpo B, Podda M, Burdio F, Sanchez-Velazquez P, Guerrero MA, Nuñez J, et al. Cost-Effectiveness of Robotic vs. Laparoscopic Surgery for Different Surgical Procedures: Protocol for a Prospective, Multicentric Study (ROBOCOSTES). Front Surg [Internet]. 2022 May 6 [cited 2023 May 28];9. Available from: https://pubmed.ncbi.nlm.nih.gov/36227017/

De Pastena M, Esposito A, Paiella S, Surci N, Montagnini G, Marchegiani G, et al. Cost-effectiveness and quality of life analysis of laparoscopic and robotic distal pancreatectomy: a propensity score-matched study. SurgEndosc [Internet]. 2021 Mar 1 [cited 2023 May 28];35(3):1420–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32240383/

Strosberg DS, Nguyen MC, Muscarella P, Narula VK. A retrospective comparison of robotic cholecystectomy versus laparoscopic cholecystectomy: operative outcomes and cost analysis. SurgEndosc [Internet]. 2017 Mar 1 [cited 2023 May 28];31(3):1436–41. Available from: https://pubmed.ncbi.nlm.nih.gov/27495346/

Ahmed K, Ibrahim A, Wang TT, Khan N, Challacombe B, Khan MS, et al. Assessing the cost effectiveness of robotics in urological surgery - a systematic review. BJU Int [Internet]. 2012 Nov [cited 2023 May 28];110(10):1544–

56. Available from: https://pubmed.ncbi.nlm.nih.gov/22443296/

Ng AP, Sanaiha Y, Bakhtiyar SS, Ebrahimian S, Branche C, Benharash P. National analysis of cost disparities in robotic-assisted versus laparoscopic abdominal operations. Surgery [Internet]. 2023 Jun 1 [cited 2023 May 28];173(6). Available from: https://pubmed.ncbi.nlm.nih.gov/36959072/

Hibner, M., Marianowski, P., Szymusik, I., &Wielgós, M. (2012). Zastosowanierobotów w chirurgiiginekologicznej [Robotic surgery in gynecology]. Ginekologiapolska, 83(12), 934–938.

Ilic, D., Evans, S. M., Allan, C. A., Jung, J. H., Murphy, D., & Frydenberg, M. (2017). Laparoscopic and robotic- assisted versus open radical prostatectomy for the treatment of localised prostate cancer. The Cochrane database of systematic reviews, 9(9), CD009625. https://doi.org/10.1002/14651858.CD009625.pub2

Hockstein, N. G., Gourin, C. G., Faust, R. A., &Terris, D. J. (2007). A history of robots: from science fiction to surgical robotics. Journal of robotic surgery, 1(2), 113–118. https://doi.org/10.1007/s11701-007-0021-2

Evans, C. R., Medina, M. G., & Dwyer, A. M. (2018). Telemedicine and telerobotics: from science fiction to reality.

Updates in surgery, 70(3), 357–362. https://doi.org/10.1007/s13304-018-0574-9

Davies, B. L., Hibberd, R. D., Ng, W. S., Timoney, A. G., & Wickham, J. E. (1991). The development of a surgeon robot for prostatectomies. Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine, 205(1), 35–38. https://doi.org/10.1243/PIME_PROC_1991_205_259_02

Mr. Kaustubh Patil, Promod Kakade. (2014). Self-Sustained Debacle Repression Using Zig-Bee Communication. International Journal of New Practices in Management and Engineering, 3(04), 05 - 10. Retrieved from http://ijnpme.org/index.php/IJNPME/article/view/32

Sherje, D. N. . (2021). Content Based Image Retrieval Based on Feature Extraction and Classification Using Deep Learning Techniques. Research Journal of Computer Systems and Engineering, 2(1), 16:22. Retrieved from https://technicaljournals.org/RJCSE/index.php/journal/article/view/14

Downloads

Published

10.11.2023

How to Cite

Nair, A. R. ., Chougule, S. ., Songa, I. R. ., Lakshmi R., V. ., Kamath, S. ., Kamath, R. ., & Verma, R. . (2023). Pecuniary Inputs and their Applications to Intelligent Decision Making in Choice of Robotic and Conventional Surgeries in Gynecologic Oncology and Urology in A Private Sector Super Speciality Tertiary Care Hospital in Southern India. International Journal of Intelligent Systems and Applications in Engineering, 12(4s), 717–722. Retrieved from https://ijisae.org/index.php/IJISAE/article/view/3857

Issue

Vol. 12 No. 4s (2024)

Section

Research Article

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

All papers should be submitted electronically. All submitted manuscripts must be original work that is not under submission at another journal or under consideration for publication in another form, such as a monograph or chapter of a book. Authors of submitted papers are obligated not to submit their paper for publication elsewhere until an editorial decision is rendered on their submission. Further, authors of accepted papers are prohibited from publishing the results in other publications that appear before the paper is published in the Journal unless they receive approval for doing so from the Editor-In-Chief.

IJISAE open access articles are licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. This license lets the audience to give appropriate credit, provide a link to the license, and indicate if changes were made and if they remix, transform, or build upon the material, they must distribute contributions under the same license as the original.