title: Minimally invasive pancreatic resections: cost and value perspectives.
abstract: The number of minimally invasive pancreatic resections (MIPR) performed for benign or malignant disease, have increased in recent years. However, there is limited information regarding cost/value implications.
  
  
  
  An international conference evaluating MIPR was held during the 12th Bi-Annual International Hepato-Pancreato-Biliary Association (IHPBA) World Congress in Sao Paulo, Brazil, on April 20th, 2016. This manuscript summarizes the presentations that reviewed current topics in cost and value as they pertain to MIPR.
  
  
  
  Compared to the open approach, MIPR's are associated with higher operative costs but lower postoperative costs. However, measurements of patient value (defined as improvement in both quantity and quality of life) and financial value (using incremental cost-effectiveness ratio) are required to determine the true value at societal level.
  
  
  
  Challenges remain as to how the potential benefits, both to the patient and the healthcare system as a whole, are measured. Research comparing MIPR versus other techniques for pancreatectomy will require appropriate and valid measurement tools, some of which are yet to be refined. Nonetheless, the experience to date would support the continued development of MIPR by experienced surgeons in high-volume pancreatic centers, married with appropriate review and recalibration.
authors.affiliation: Professorial Surgical Unit, Trinity College Dublin, The University of Dublin, Ireland. Electronic address: profsurg@tcd.ie.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Conlon
authors.affiliation: Department of Surgery, Amsterdam Medical Center, Amsterdam, The Netherlands.
authors.forename: Thijs
authors.initials: T
authors.lastname: de Rooij
authors.affiliation: Department of Surgery, Amsterdam Medical Center, Amsterdam, The Netherlands.
authors.forename: Jony
authors.initials: J
authors.lastname: van Hilst
authors.affiliation: Department of Surgery, University of Southampton, United Kingdom.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Abu Hidal
authors.affiliation: Pancreatic Cancer Action Network, Manhattan Beach, CA, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Fleshman
authors.affiliation: Department of Surgery, North Shore University Health System, Chicago, IL, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Talamonti
authors.affiliation: Gerald Bronfman, Department of Oncology, McGill University, Montreal, Canada.
authors.forename: Tsafrir
authors.initials: T
authors.lastname: Vanounou
authors.affiliation: Gerald Bronfman, Department of Oncology, McGill University, Montreal, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Garfinkle
authors.affiliation: Division of General Surgery, The University of South Florida, Tampa, FL, USA.
authors.forename: Vic
authors.initials: V
authors.lastname: Velanovich
authors.affiliation: Department of Surgery, Emory University, Atlanta, GA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Kooby
authors.affiliation: Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Vollmer
mesh_terms: D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics*; D018803:Models, Economic; D010180:Pancreatectomy / Q000009:adverse effects / Q000191:economics*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000191:economics*; D011788:Quality of Life; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000191:economics*; D016896:Treatment Outcome