Economic and utilization analysis of robot-assisted versus laparoscopic live donor nephrectomy.
BACKGROUND
Reports of robot-assisted live donor nephrectomies (LDNs) have been emerging in the literature. We sought to examine the national incidence of robot-assisted LDNs and to assess regional use and economic differences in robot-assisted versus laparoscopic LDN.


METHODS
Data from the Nationwide Inpatient Sample (NIS) were used to identify patients who underwent either laparoscopic or robot-assisted LDN between 2009 and 2011. Descriptive analysis was performed to examine differences between the laparoscopic and robot-assisted groups.


RESULTS
A total of 4,163 cases of LDN were performed using robot-assistance or pure laparoscopic surgery between 2009 and 2011. Of these, 142 were classified as robot-assisted nephrectomies; these cases were all from the western United States. There was no difference in the incidence of complications between the laparoscopic and robot-assisted groups (P=0.206). Median (interquartile range [IQR]) total charges for robot-assisted LDN were $48,639 ($42,380-$53,050) vs $37,019 ($28,715-$48,816) for laparoscopic cases (P<0.001).


CONCLUSIONS
The role of robotic assistance in LDN remains to be determined; we identified no benefits to robotic assistance in our study.
Department of Urology, Indiana University School of Medicine , Indianapolis, Indiana.
M Francesca
MF
Monn
Alec R
AR
Gramm
Clinton D
CD
Bahler
David Y
DY
Yang
Chandru P
CP
Sundaram
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D019520:Living Donors; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012371:Robotics / Q000191:economics* / Q000706:statistics & numerical data; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D014481:United States