Cost Analysis of Robotic Surgery of the Head and Neck

Abstract

Objective: 1) Present results of cost identification analysis for robotic head and neck surgical procedures. 2) Identify drivers of cost for robotic procedures in the persioperative period including services, materials, and patient characteristics.

Method: Retrospective review of 128 robotic surgical procedures of the head and neck at an academic medical center between 2008 and 2011. Cost data for the perioperative period (operating room, recovery, hospital stay) were collected and matched with clinical data for each case to determine drivers of cost.

Results: Procedures analyzed included transoral robotic surgery (TORS) for oropharyngeal and supraglottic cancers, transaxillary robotic thyroidectomy, and transoral robot assisted approaches to the skull base. Average total cost was $14,455 with a wide range of $3,567-$55,008. In a subset of 24 patients who underwent TORS alone, without neck dissection, the average cost was $6,450. The cost of the robot for these procedures is analyzed in relation to surgical volume. A subset of patients who underwent TORS with neck dissection for oropharyngeal cancer is analyzed in order to determine drivers of cost in a homogenous group.

Conclusion: Costs attributed to the surgical robot contribute a modest proportion of the total cost of procedures of the head and neck utilizing the robot at a high volume robotic surgery center. Further study examining the cost-effectiveness of robotic surgery in comparison to other treatment modalities is indicated.