Objectives: The purpose of this study was to compare the costs of traditional laparoscopy and robotic-assisted laparoscopy in the treatment of endometrial cancer.
Methods And Materials: A total of 101 patients with endometrial cancer were randomized to the study and operated on starting from 2010 until 2013, at the Department of Obstetrics and Gynecology of Tampere University Hospital, Tampere, Finland. Costs were calculated based on internal accounting, hospital database, and purchase prices and were compared using intention-to-treat analysis. Main outcome measures were item costs and total costs related to the operation, including a 6-month postoperative follow-up.
Results: The total costs including late complications were 2160 &OV0556; higher in the robotic group (median for traditional 5823 &OV0556;, vs robot median 7983 &OV0556;, P < 0.001). The difference was due to higher costs for instruments and equipment as well as to more expensive operating room and postanesthesia care unit time. Traditional laparoscopy involved higher costs for operation personnel, general costs, medication used in the operation, and surgeon, although these costs were not substantial. There was no significant difference in in-patient stay, laboratory, radiology, blood products, or costs related to complications.
Conclusions: According to this study, robotic-assisted laparoscopy is 37% more expensive than traditional laparoscopy in the treatment of endometrial cancer. The cost difference is mainly explained by amortization of the robot and its instrumentation.
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http://dx.doi.org/10.1097/IGC.0000000000001073 | DOI Listing |
Langenbecks Arch Surg
January 2025
Alexandria Main University Hospital, Alexandria, Egypt.
Background: Patients with prior abdominal surgeries are at higher risk of intra-peritoneal adhesions near the trocar entry site, increasing the likelihood of organ injury during laparoscopic cholecystectomy (LC). This study evaluates a novel technique where the epigastric trocar is inserted first, after creating pneumoperitoneum, to allow safe dissection of adhesions under direct vision before placing the umbilical trocar.
Methods: This prospective study included 244 patients with symptomatic uncomplicated gallstone disease and a history of previous abdominal surgeries extending to the umbilicus.
J Med Internet Res
January 2025
I3A, LoUISE Research Group, University of Castilla-La Mancha, Albacete, Spain.
Background: Laparoscopic surgery training is a demanding process requiring technical and nontechnical skills. Surgical training has evolved from traditional approaches to the use of immersive digital technologies such as virtual, augmented, and mixed reality. These technologies are now integral to laparoscopic surgery training.
View Article and Find Full Text PDFWorld J Gastrointest Surg
January 2025
Department of Hepatobiliary Surgery, Affiliated Nantong Hospital Third of Nantong University, Nantong 226006, Jiangsu Province, China.
Background: Intraoperative and postoperative biliary injuries remain significant complications of laparoscopic common bile duct exploration (LCBDE). Indocyanine green (ICG) has been shown to significantly reduce injuries caused by intraoperative operational errors. We found that the J-tube can reduce postoperative strictures and injuries to the common bile duct.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Gastroenterology, Clinic Donaustadt, SMZ-Ost, Langobardenstrasse 122, A-1220 Vienna, Austria.
Gastroesophageal reflux disease (GERD) affects millions globally, with traditional treatments like proton pump inhibitors (PPIs) and surgical fundoplication presenting challenges such as long-term medication dependency and disturbing long term side effects following surgery. This review explores emerging, alternative therapies that offer less invasive, personalized alternatives for GERD management. Endoscopic approaches, including Stretta therapy, transoral incisionless fundoplication (TIF), and endoscopic full-thickness plication (EFTP), demonstrate promising but also controversial outcomes in symptom relief and reduced acid exposure.
View Article and Find Full Text PDFJ Vasc Surg
January 2025
Department of Vascular Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University. Electronic address:
Objective: Acute mesenteric artery obstruction is a severe cause of acute mesenteric ischemia, associated with significant morbidity and mortality. However, there is limited guidance on choosing between traditional and minimally invasive techniques comprehensively. This study introduces a selective, minimally invasive strategy designed to improve the survival and prognosis of patients with acute superior mesenteric artery obstruction.
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