Upfront costs of robotic heart surgery are high—but it may be a smart investment
New cost and outcomes research on mitral robotic surgery presented at the American Association for Thoracic Surgery (AATS) annual meeting suggests it may cost more in the operating room, but can generate downstream benefits through faster recovery, shorter hospital stays and lower readmission rates.
Cardiovascular Business spoke with the presenter of that research, Makoto Hashimoto, MD, PhD, professor and director of robotic cardiac surgery at Florida International University, Baptist Health, for a new video interview. He and his team explored data from more than 8,000 patients undergoing isolated mitral valve repair, including 780 who were treated with robotic surgery. They then compared robotic procedures against conventional surgical approaches using data from the Premier Healthcare Database.
“The overall cost includes the capital equipment, the maintenance and all those disposable instrument costs, and those are increasing the cost in the OR,” Hashimoto explained. “But I don’t think robotic surgery is just an expensive procedure. I think it’s differently structured care. There’s objectively fewer ICU stays, a shorter length of hospital stay, and lower 30-day readmission rate. These are advantages in clinical settings for robotic surgeries.”
Procedural expenses averaged $57,678 for the robotic procedures $51,530 for traditional surgical procedures. However, patients undergoing robotic surgery experienced improved clinical outcomes. This included a reduction in time spent in the ICU (2.4 vs. 2.8 days), shorter hospital lengths of stay (5.7 vs. 6.8 days), and a lower 30-day readmission rate (3.1% vs. 4.9%). There were no differences in procedure time, complication rates or mortality.
Hashimoto argued that evaluating robotic surgery solely on direct hospital procedural costs overlooks broader economic and quality-of-life benefits. Faster patient recovery also reduces disruptions to work, family life and other social activities, while hospitals may benefit from lower readmissions and improved patient satisfaction.
More robotic surgeries are performed at non-academic centers
The findings also highlighted an unexpected trend, where most robotic cardiac procedures are now being performed at non-academic medical centers rather than large university hospitals. Hashimoto said the expansion reflects how robotic cardiac surgery has become increasingly standardized and commercially viable beyond major academic institutions. He also offered his opinions on why robotic surgery has expanded at non-academic hospitals.
“Private hospitals have more robots for everybody, and we don’t need to compete with other doctors to use the robots,” he said.
Hashimoto added that community and private hospitals may also see robotic surgery as a strategic investment that attracts patients seeking minimally invasive treatment options and the latest technology.
“I think robotic surgery is the way to go,” Hashimoto said. “It has very good clinical impact, and patients really love robotic surgery.”
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]