Cost-conscious robotic restorative proctectomy has similar economic and oncologic outcomes to open restorative proctectomy: Results of a long-term follow-up study

Background: In this study, we hypothesised that the direct hospital costs of robotic restorative proctectomy (RP) would be similar to those of open RP when a cost-conscious approach was employed in rectal cancer patients. Methods: We included consecutive patients with rectal cancer who underwent RP between 12/2011 and 10/2014. A cost-conscious approach was employed in robotic surgery. We compared demographics, long-term oncologic outcomes, and direct hospital costs between the open and robotic groups. Results: There were 32 robotic and 68 open RP procedures performed. Compared to open RP, the robotic RP group had a longer operative time but less estimated blood loss, intraoperative transfusions, overall short-term morbidity, decreased length of stay. After the initial five robotic cases, overall hospital costs were comparable between the groups (1 ± 0.5 vs. 1 ± 0.4, open and robotic RP, respectively, p = 0.90). Conclusion: Increasing surgeon experience and a cost-conscious approach may improve the value of care of robotic RP in patients with rectal cancer.