Robot-Assisted Laparoscopic Colorectal Surgery Cost and Complications

 

Lap Trainer Box

Lap Trainer Box

History of Robotic-Assisted Laparoscopy

25 years ago now appeared the surgery colorectal laparoscopy. She was controversial and fought. He had to demonstrates, by of name-pre-uses studies, his interest and his profits for the patients and the system of health before to validates through administrative authorities and learned societies.

Use of Simulation for Laparoscopy Training with Lap Trainer Box is Significant.

When, about ten years ago, an electronic tele-manipulator (which some have called a “robot") was introduced, it immediately aroused the enthusiasm of surgeons. These are in general from “geeks”, and the first conquered users explained the difficulty to stop after to have try (addiction).

In contrary, so, at the surgery laparoscopic, the enthusiasm for this tool was immediate without any study proving its interest for patients and the system of health.

The objective of this article is to analyze the data of the literature concerning the usefulness, to date, for patients, the surgeons and the systems of care, of this sophisticated tool and expensive.

Interest for patients

All first of all, in analyzing the statistics of insurance sickness (CCAM) between 1993 and 2013, we are impressed by the evolution of laparoscopy in surgery colorectal in the convenient surgeons colorectal.

The Practice of Laparoscopy in Surgery

Colorectal disease has in fact increased in 20 years from 1% (1993) to 50% (2012), progressing every 10 years from 25 %, that is 2.5 % through year. Thereby, it is close of 90 % (Less than 1% by robotics) and nearly 60% of rectal cancers that are currently operated on by laparoscopy.

The introduction of robotic tools thought to allow the development of Minimally Invasive Surgery. The progression should of the laparoscopy that is superior at 2.5 % per year, which is far from demonstrates.

Complications

First, one of the first points to study is the rate of morbidity, and therefore of complications, which would be lesser what about surgery opened where laparoscopic. That is false. Party, which have could analyze the statistics from insurance companies regarding laparoscopic prostatectomies assisted through the robot They collected 1,460 complications out of 321,361 robot-assisted interventions , if all complications are included (anaesthetic, infectious, pulmonary, due at from errors surgical). The authors rectopexies for prolapse of the rectum (whose conclusions show a similar rate of complications.

Strong Points

•           The surgery of laparoscopic colorectal is now a quarter of century of existence. Since a decade, she considers like the “Gold Standard" in the processing surgical from colorectal pathologies.

•           The laparoscopy assisted through robot n / a show at this day any advantage for the patient in the domain of the surgery colorectal and does not improve in nothing the quality from results oncology and functional.

•           This surgery presents an unjustified additional cost in view of the published results.

Colon Rectum Robotics

Cost

One of the purposes of introducing new technologies or new tools is to propose the best care in controlling the expenses paid through the patients and or the systems of care, like this was the case with the laparoscopy. The robotic surgery, Also Good general than colorectal, is marked through an additional cost important of through intervention, without hold account Cost from robot (of 450 000 at 1,875 million), of the maintenance annual (of 75 000 at 127 500), from additional cost from to staff additional and from durations operating more long. Strong fortunately in our system audience, he not there at not, like in some country, of additional cost billing to patient (of 5 000 at 10 000 for the hospital and/or the surgeon sometimes paid for by the insurance private).

Of more, any study does not include the cost of the training from teams (3100 per day of training). Unlike laparoscopic surgery, the additional costs do not associates at a fall from cost of hospitalization, nor to a duration of stay more short and at a recovery more fast from patients. It is With regard to the medical benefit for patients.

Conclusion

Publications on laparoscopic colorectal surgery where without robot are very numerous, 95 % from publications concern the robotics in colorectal surgery, but it only represents 3% from talks realized in the domain of Minimal Invasive Colorectal Surgery. The analysis of the literature is so difficult, because she is filled with items supporters who have for the mostly from time the goal of value the tool and the team who uses it, and of conclude than it is "feasible" and sure, with potential benefits. However, we can find from works recent who honestly evaluate the interest of the tool.

For more information visit our website: www.gerati.com

 

Comments

Post a Comment

Popular posts from this blog

Endoscopy, Intraoperative and Postoperative Retrospective Analysis

Image
  Introduction Since the introduction of POEM into clinical practice, more and more publications have appeared that indicate the high efficacy and safety of this intervention. Conducted a meta-analysis of 2373 cases from 36 institutions in 12 countries and indicating an early intervention success rate of 98%. During their internship in laparoscopic technique, many of them have not received practical training with simulators Laparoscopic Trainer Box . When searching the literature, we found several large clinical studies comparing POEM with balloon dilatation and laparoscopic Heller myotomy. According to these studies, POEM provides a better result than pneumatic dilation, but similar to the result of laparoscopic Geller myotomy, and its important advantage is its high efficiency in type 3 AP due to the possibility of increasing the length of myotomy. Results in Postoperative Period POEM is also a possible and safe treatment option for recurrent AP, including after an unsu...
Read more

Introduction to Basic Laparoscopic Surgery

Image
  Overview Laparoscopy is a seductive minimally invasive surgical technique, more and more widespread in the practice of veterinary medicine, making it possible to make diagnoses (exploration of the abdomen, biopsies) or conventional surgeries (oophorectomy). For minimally invasive surgery technique many of them have not received practical training with simulators Laparoscopic Endo Trainer . Introduction to Laparoscopy This technique is associated with reduced postoperative pain, rapid postoperative recovery and a low rate of complications. To get started, specific training and the acquisition of the appropriate equipment are necessary. Building on advances in human medicine, veterinary surgeons quickly gained access to laparoscopic surgery, also known as laparoscopy. This enabled a major breakthrough in the rapidly expanding field of minimally invasive surgery. The aim of this article is to describe the general principles inherent in laparoscopy as well as the necessary eq...
Read more

Laparoscopic Surgery in Oncology, Rectum and Use of Robotics

Image
  The hypothesis according to which the pneumoperitoneum favors the seeding of the abdominal cavity by malignant cells, has demonstrated by study. Laparoscopy is ultimately only the first approach and that as long as the principles of oncological surgery applied and considered in oncological surgery. Laparoscopy results respected and are identical to open surgery. The hypothesis, according to which laparoscopy would provide better results, remains to be demonstrated. However, and despite recent technological developments, some indications remain controversial, either because of too high technical requirements, or because of the lack of scientific validity. For a large number of reasons use of simulators is a prudent choice like Laparoscopic Needle Holder . Advanced Laparoscopic Surgery in Oncology Rectum While the benefits of laparoscopic colectomy surgery for colon cancer have demonstrated by prospective randomized studies. The value of laparoscopic treatment of rectal c...
Read more