Maida, Giorgio (2013) The Da Vinci surgical robot clinical operating assessment. Doctoral Thesis.
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This work aims at study as robotic surgery with DaVinci robot may influence clinical results and economic expenditure in two surgical Departments in S. Francesco Hospital, Nuoro.
A series of anagrafics/healthy/outcome indicators has been formulated, finding the costs correlated to them.
Patients: 66 undergone robotic/open (46/20) retropubic radical prostatectomy (PPR) and 52 undergone robotic/laparoscopic (30/22) right hemicolectomy (EMI)
PPR - Since the arrival of the robot, attractiveness is raised.
Perioperative blood loss is less frequent in robotic procedures (2,2% vs 55%, p =.001) and with less blood amount (500 vs 891 cc), as it is for peri-/intra-operative complications (0% vs 10% and 19,5% vs 40%).
Robotic PPR allows a 2-days anticipated patients discharge (p =.002) and a 1-day bladder catheter removal (p<.005).
EMI - Globally, comparison shows no differences. There are a few advantages for robotic procedures in time of patient discharge (1 day), percentage of patient transfused and adverse events, although none of these shows statistical significance.
Surgical time appears a critical parameter for both procedures, although less in EMI.
Costs are calculated in PPR, including fixed (purchase/maintenance/instruments) and variable (clinical/other) ones. A difference of €33.337/procedure is found, to the detriment of robotic surgery.
Robotic surgery is an effective, attractive and evolving technology, although economic expenditure remains an obstacle to the diffusion of robots.
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