Chandra, Amitabh, Julia Thornton Snider, Wu Yanyu, Anupam Jena, and Dana Goldman. "Robot-Assisted Surgery For Kidney Cancer Increased Access To A Procedure That Can Reduce Mortality And Renal Failure." Health Affairs 34.2 (February 2015): 220-228.
Surgeons increasingly use robot-assisted minimally invasive surgery for a variety of medical conditions. For hospitals, the acquisition and maintenance of a robot requires a significant investment, but financial returns are not linked to any improvement in long-term patient outcomes in the current reimbursement environment. Kidney cancer provides a useful case study for evaluating the long-term value that this innovation can provide. Kidney cancer is generally treated through partial or radical nephrectomy, with evidence favoring the former procedure for appropriate patients. We found that robot-assisted surgery increased access to partial nephrectomy and that partial nephrectomy reduced mortality and renal failure. The value of the benefits of robotassisted minimally invasive surgery to patients, in terms of qualityadjusted life-years gained, outweighed the health care and surgical costs to patients and payers by a ratio of five to one. In addition, we found no evidence that the availability of robot-assisted minimally invasive surgery increased the likelihood that inappropriate patients received partial nephrectomy.