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Minimally invasive distal pancreatectomy and the cost of conversion
Author(s) -
Stewart Camille L.,
Wong Paul,
Selby Luke,
Warner Susanne G.,
Raoof Mustafa,
Singh Gagandeep,
Fong Yuman,
Melstrom Laleh G.
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25852
Subject(s) - medicine , pancreatectomy , distal pancreatectomy , surgery , general surgery , resection
Background Minimally invasive surgery (MIS) is preferred for distal pancreatectomy but is not always attempted due to the risk of conversion to open. We hypothesized that the total cost for MIS converted to open procedures would be comparable to those that started open. Methods A prospectively collected institutional registry (2011‐2017) was reviewed for demographic, clinical, and perioperative cost data for patients undergoing distal pancreatectomy. Results There were 80 patients who underwent distal pancreatectomy: 41 open, 39 MIS (11 laparoscopic and 28 robotic). Conversion to open occurred in 14 of 39 (36%, 3 laparoscopic and 11 robotic). Length of stay was shorter for the MIS completed (6 days; range, 3‐8), and MIS converted to open (7 days; range, 4‐10) groups, compared with open (10 days; range, 5‐36; P = .003). Laparoscopic cases were the least expensive ( P = .02). Robotic converted to open procedures had the highest operating room cost. However, the total cost for robotic converted to open cohort was similar to the open cohort due to cost savings associated with a shorter length of stay. Conclusions Despite the higher intraoperative costs of robotic surgery, there is no significant overall financial penalty for conversion to open. Financial considerations should not play a role in selecting a robotic or open approach.