title: Single-incision robotic colectomy: are costs prohibitive?
abstract: BACKGROUND
  The feasibility, safety, and costs of single-incision robotic colectomy (SIRC) are not known.
  
  
  METHODS
  A retrospective review was conducted, comparing the initial 29 consecutive SIRC procedures performed to 36 multiport laparoscopic colectomies (MLC).
  
  
  RESULTS
  The groups did not differ significantly on age, body mass index, gender, ASA classification, smoking status, steroid usage or rate of diabetes. Procedure time, conversion rate, infectious complications and length of stay did not differ significantly. The ratio of observed:expected direct hospital costs statistically favoured MLC, although there was no statistical difference between groups for contribution margin, or for observed and expected direct hospital costs.
  
  
  CONCLUSIONS
  These results demonstrate safety and technical feasibility for SIRC in selected patients with short-term outcomes and hospital costs comparable to MLC. Contribution margin remained positive and expected costs exceeded observed for SIRC. Increased costs for SIRC are a concern. The comparable but relatively high mortality in both groups may represent an institutional approach to colectomy where significant comorbidity is not a contraindication to minimally invasive surgery. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Departments of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Byrn
authors.affiliation: Departments of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Hrabe
authors.affiliation: Departments of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: John G
authors.initials: JG
authors.lastname: Armstrong
authors.affiliation: Departments of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Anthony
authors.affiliation: Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Charlton
mesh_terms: D000328:Adult; D000368:Aged; D003082:Colectomy / Q000191:economics / Q000379:methods*; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000379:methods; D061646:Operative Time; D061214:Patient Safety; D011183:Postoperative Complications; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome
keywords: colorectal surgery; robotic colectomy; single-incision colectomy