Economic assessment in minimally invasive thoracic oncological surgery—USA experience

Minimally invasive techniques have rapidly been adopted in the surgical management of thoracic pathologies. These modalities including video-assisted thoracic surgery (VATS) and more recently robotic-assisted thoracic surgery (RATS) confer a number of advantages including enhanced recovery and the potential for improved surgical precision. However, the implementation of minimally invasive techniques does result in increased up-front costs associated with the acquisition of necessary equipment. Furthermore, particularly early in the implementation of a minimally invasive approach, increased operative times are incurred. However, these disadvantages may be offset by the purported benefits of a minimally invasive approach, which collectively may reduce hospital length of stay and complication rate. As the costs of care come under greater scrutiny an understanding of both the prevalence of minimally invasive thoracic surgery and its associated drivers of cost is imperative. Herein, the costs associated with minimally invasive thoracic surgical oncologic procedures are reviewed.