Robotic surgery is gaining traction in Japan due to its technological advancements, but its financial viability for hospitals remains uncertain. This study investigates the impact of robotic surgery on hospital gross profits, comparing it to laparoscopic surgery using data from surgeries performed at Red Cross Hospital Osaka. The study spans multiple surgical fields, including gastrointestinal, urology, gynecology, and thoracic surgery. While the number of robotic surgeries has increased, they consistently generate lower gross profits for hospitals compared with laparoscopic surgeries, primarily due to the high costs of robotic instruments and maintenance. Certain procedures, such as hernia repair, proximal gastrectomy, and distal pancreatectomy, result in negative profits when performed robotically. This article highlights the financial challenges hospitals face under Japan's current healthcare reimbursement system, where the fees for robotic and laparoscopic surgeries are largely the same. Policy adjustments may be necessary to ensure the financial sustainability of robotic surgery.
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http://dx.doi.org/10.1111/ases.13410 | DOI Listing |
Knee Surg Sports Traumatol Arthrosc
January 2025
Orthopaedic Robotics Laboratory, Departments of Bioengineering and Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Purpose: To quantify the effect of increasing the posterior tibial slope (PTS) on knee kinematics and the resultant medial and lateral meniscal forces.
Methods: In this controlled laboratory study, a 6 degrees of freedom (DOF) robotic testing system was used to apply external loading conditions to seven fresh-frozen human cadaveric knees: (1) 200-N axial compressive load, (2) 5-N m internal tibial +10-N m valgus torque and (3) 5-N m external tibial + 10-N m varus torque. Knee kinematics and the resultant medial and lateral meniscal forces were acquired for two PTS states: (1) native PTS and (2) increased PTS.
Ann Surg Oncol
January 2025
AdventHealth Tampa, Digestive Health Institute, Tampa, Florida, USA.
J Robot Surg
January 2025
Department of Pediatric Anesthesia and Intensive Care, Necker-Enfants Malades University Hospital, AP-HP Centre, Université Paris Cité, 149, Rue de Sèvres 75015, Paris, France.
Retroperitoneal robotic-assisted laparoscopic pyeloplasty (R-RALP) is the commonest urologic procedure performed in children, entailing retroperitoneal CO2 insufflation and lateral decubitus, whose effects on cardiopulmonary variables are poorly known. We, therefore, studied hemodynamic and respiratory changes due to CO2 insufflation and lateral decubitus in children undergoing R-RALP and their effects on regional tissue oxygenation. Between 1/2021 and 7/2024, children affected by ureteropelvic joint obstruction (UPJO) underwent a pyeloplasty by R-RALP at Necker Enfants Malades Hospital (Paris, France), using a standardized surgical technique and a lung-protecting anesthetic protocol aimed to prevent hypercarbia.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Department of Cardiovascular Surgery, Sapporo Cardio Vascular Clinic, 8-1, Kita 49 jyo, Higashi 16 jyo, Higashi-ku, Sapporo, Hokkaido, 007-0849, Japan.
Background: Minimally invasive cardiac surgery for mitral regurgitation is challenging in patients with narrow chests due to limited thoracic space. The butterfly technique can prevent systolic anterior motion in patients with degenerative mitral regurgitation and redundant posterior leaflets, but it is difficult to perform via minimally invasive cardiac surgery. Few reports have described mitral valve repair using the butterfly technique or in a narrow chest.
View Article and Find Full Text PDFJ Robot Surg
January 2025
Department of General Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Robotic surgery is extensively used for rectal cancer treatment. Nonetheless, studies on whether to preserve the left colonic artery (LCA) during robotic rectal cancer surgery to reduce complications remain scarce and controversial. This study compared short-term outcomes of high tie (HT) and low tie (LT) ligation of the inferior mesenteric artery in 455 patients undergoing robotic rectal cancer surgery between May 2018 and July 2022.
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