584 COMPARING COSTS OF ROBOTIC, LAPAROSCOPIC, AND OPEN PARTIAL NEPHRECTOMY

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You have accessJournal of UrologyKidney Cancer: Evaluation and Staging I1 Apr 2012584 COMPARING COSTS OF ROBOTIC, LAPAROSCOPIC, AND OPEN PARTIAL NEPHRECTOMY Mehrdad Alemozaffar, Steven Chang, Ravi Kacker, Maryellen Sun, William DeWolf, and Andrew Wagner Mehrdad AlemozaffarMehrdad Alemozaffar Boston, MA , Steven ChangSteven Chang Boston, MA , Ravi KackerRavi Kacker Boston, MA , Maryellen SunMaryellen Sun Boston, MA , William DeWolfWilliam DeWolf Boston, MA , and Andrew WagnerAndrew Wagner Boston, MA View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.660AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic and robotic partial nephrectomy (LPN and RPN) are common minimally invasive alternatives to open partial nephrectomy (OPN) for management of renal tumors. Cost discrepancies of these approaches warrants evaluation. We compared hospital costs associated with RPN, LPN, and OPN at a tertiary care teaching institution. METHODS Variable costs (VC) included operating room (OR) time, supplies, anesthesia, inpatient care, radiology, pharmacy, and laboratory costs. Fixed costs (FC) included equipment purchase and maintenance. VC and FC were captured for 25 patients in each group who underwent RPN, LPN, OPN at our institution between November 2008 through September 2010. The impact of VC and FC were estimated using various sensitivity analysis. RESULTS We found similar VC for RPN, LPN, and OPN ($6,375 vs $6,075 vs $5,774, p=0.116, respectively). OR supplies contributed greater cost for RPN and LPN than OPN ($2,179 vs. $1,987 vs. $181, p<0.0001, respectively), while the inpatient stay cost was higher for OPN compared to LPN and RPN ($2,418 vs. $1,305 vs. $1,274, p<0.0001, respectively). (Fig 1) Sensitivity analysis for VC demonstrated that RPN and LPN can be less costly than OPN (with OPN parameters held constant) if the average hospital stay for RPN and LPN is <2 days and OR time is <204 and 196 minutes, respectively. (Fig 2) When FC are included, cost equivalence of RPN and LPN to OPN requires even shorter operative times and length of stay, with increased utilization of RPN and LPN equipment. (Fig 3). CONCLUSIONS There was no difference among VC for RPN, LPN, and OPN at our institution. By minimizing OR time and length of hospital stay, it is possible for RPN and LPN to be cost equivalent to OPN. With FC included, RPN and LPN were more costly than OPN, but equivalence may be possible with improvements in efficiency and utilization. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e238 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mehrdad Alemozaffar Boston, MA More articles by this author Steven Chang Boston, MA More articles by this author Ravi Kacker Boston, MA More articles by this author Maryellen Sun Boston, MA More articles by this author William DeWolf Boston, MA More articles by this author Andrew Wagner Boston, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...