Robotic Surgery Provides Healthcare and Economic Benefits

A new study concludes that partial nephrectomies for kidney cancer patients have significantly lower rates of renal failure when compared with radical nephrectomies.

Researchers at Harvard University (Cambridge, MA, USA), Precision Health Economics (Los Angeles, CA, USA) and other institutions used data from the U.S. national cancer registry to identify 26,789 Medicare beneficiaries who were diagnosed with kidney cancer between 1996 and 2010, and whom underwent a subsequent nephrectomy. Patient cost and outcome data were derived from the Surveillance, Epidemiology, and End Results (SEER) program, as linked to Medicare claims.

The researchers found that adoption of robotic-assisted minimally invasive surgery (MIS) led to a 52% increase in the rate of kidney sparing partial nephrectomy versus full radical nephrectomy. The value of the benefits of robot-assisted MIS to patients, in terms of quality-adjusted life-years gained, outweighed the health care and surgical costs to both patients and payers by a ratio of five to one. In addition, they found no evidence that the availability of robot-assisted MIS increased the likelihood that inappropriate patients received partial nephrectomy.

The five-year net benefit per procedure (in terms of the difference between quality-adjusted survival gains and health care costs incurred) was USD 106,344 for each patient who received partial rather than radical nephrectomy. The researchers concluded that if all hospital referral regions (HRRs) had adopted the Intuitive Surgical (Sunnyvale, CA, USA) da Vinci surgical system, an additional 23,166 partial nephrectomies would have been performed over the study period, generated an additional USD 2.5 billion in value. The study was published in the February 2015 issue of Health Affairs.

“Partial nephrectomy, or kidney-sparing surgery, is considered the standard of care for clinically appropriate patients as a means to slow the progression of renal failure and reduce the risk of dialysis,” said Myriam Curet, MD, chief medical officer of Intuitive Surgical. “The PHE study demonstrates that those hospitals offering minimally invasive partial nephrectomies utilizing a da Vinci surgical system delivered both improved patient outcomes and considerable long-term economic benefits.”

“The preferred and healthiest option to cure a small renal cancer is to perform a partial nephrectomy,” commented professor of urology Sam Bhayani, MD, MSc, of Barnes-Jewish West County Hospital (Saint Louis, MO, USA), who was not involved in the research. “The most effective way for a hospital and surgeon to perform partial nephrectomy is to have access to robotic surgery.”

Related Links:
Harvard University
Intuitive Surgical
Barnes-Jewish West County Hospital