Rouault A, Pecquenard F, Elamrani M, Boleslawski E, Truant S, Millet G
Lille University Hospital, Lille, France.
J Robot Surg. 2025 Apr 14;19(1):156. doi: 10.1007/s11701-025-02319-z.
Robotic-assisted hepatectomy has gained traction in hepatobiliary surgery, but its cost-effectiveness compared to traditional surgical approaches remains unclear. This study investigates clinical outcomes and financial implications of robotic-assisted liver surgery in a high-volume center, comparing it with open and laparoscopic methods. A retrospective cohort study was conducted on patients undergoing hepatectomy at Lille University Hospital in 2018 and 2021, performed by the institution's first experienced robotic hepatobiliary surgeon. Data on patient demographics, intraoperative details, postoperative outcomes, and costs were analyzed. Costs included hospital stays, surgical materials, and complications, derived from national cost studies. A total of 111 patients were included, with a rise in minimally invasive procedures from 47.5% in 2018 to 75% in 2021. Robotic-assisted hepatectomy was associated with reduced hospital stays, lower complication rates, and fewer severe morbidities compared to laparotomy. The average cost per procedure (all surgical approaches combined) decreased from €12,169 in 2018 to €8,513 in 2021, with robotic surgery offering a significant financial advantage. The total savings for the 71 patients in the 2021 cohort was €259,576, driven primarily by reduced hospitalization times and fewer complications. Robotic-assisted hepatectomy is clinically safe and cost-effective, offering substantial financial savings over traditional surgery. The reduction in postoperative complications and hospital stay durations, particularly for complex cases, highlights the advantages of robotic surgery in hepatobiliary procedures. As surgical expertise increases, robotic surgery represents a sustainable and efficient alternative in liver resection.
机器人辅助肝切除术在肝胆外科手术中越来越受到关注，但其与传统手术方法相比的成本效益仍不明确。本研究调查了在一个高容量中心进行机器人辅助肝脏手术的临床结果和财务影响，并将其与开放手术和腹腔镜手术方法进行比较。对2018年和2021年在里尔大学医院接受肝切除术的患者进行了一项回顾性队列研究，手术由该机构第一位经验丰富的机器人肝胆外科医生进行。分析了患者人口统计学、术中细节、术后结果和成本的数据。成本包括住院时间、手术材料和并发症，这些数据来自国家成本研究。总共纳入了111名患者，微创程序的比例从2018年的47.5%上升到2021年的75%。与开腹手术相比，机器人辅助肝切除术与缩短住院时间、降低并发症发生率和减少严重发病率相关。每个手术程序的平均成本（所有手术方法合计）从2018年的12,169欧元降至2021年的8,513欧元，机器人手术具有显著的财务优势。2021年队列中的71名患者总共节省了259,576欧元，主要是由于住院时间缩短和并发症减少。机器人辅助肝切除术在临床上是安全且具有成本效益的，与传统手术相比可节省大量资金。术后并发症和住院时间的减少，特别是对于复杂病例，凸显了机器人手术在肝胆手术中的优势。随着手术专业知识的增加，机器人手术是肝切除术中一种可持续且高效的替代方法。
