Skip to main content
Erschienen in: Surgical Endoscopy 4/2021

14.04.2020

Workplace absenteeism amongst patients undergoing open vs. robotic radical prostatectomy, hysterectomy, and partial colectomy

verfasst von: Daniel Pucheril, Sean A. Fletcher, Xi Chen, David F. Friedlander, Alexander P. Cole, Marieke J. Krimphove, Adam C. Fields, Nelya Melnitchouk, Adam S. Kibel, Prokar Dasgupta, Quoc-Dien Trinh

Erschienen in: Surgical Endoscopy | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Abstract

Background

There is controversy regarding the widespread uptake of robotic surgery across several surgical disciplines. While it has been shown to confer clinical benefits such as decreased blood loss and shorter hospital stays, some argue that the benefits of this technology do not outweigh its high cost. We performed a retrospective insurance-based analysis to investigate how undergoing robotic surgery, compared to open surgery, may impact the time in which an employed individual returns to work after undergoing major surgery.

Methods

We identified a cohort of US adults with employer-sponsored insurance using claims data from the MarketScan database who underwent either open or robotic radical prostatectomy, hysterectomy/myomectomy, and partial colectomy from 2012 to 2016. We performed multiple regression models incorporating propensity scores to assess the effect of robotic vs. open surgery on the number of absent days from work, adjusting for demographic characteristics and baseline absenteeism.

Results

In a cohort of 1157 individuals with employer-sponsored insurance, those undergoing open surgery, compared to robotic surgery, had 9.9 more absent workdays for radical prostatectomy (95%CI 5.0 to 14.7, p < 0.001), 25.3 for hysterectomy/myomectomy (95%CI 11.0–39.6, p < 0.001), and 29.8 for partial colectomy (95%CI 14.8–44.8, p < 0.001)

Conclusion

For the three major procedures studied, robotic surgery was associated with fewer missed days from work compared to open surgery. This information helps payers, patients, and providers better understand some of the indirect benefits of robotic surgery relative to its cost.
Literatur
1.
2.
Zurück zum Zitat Gandaglia G, Sammon JD, Chang SL et al (2014) Comparative effectiveness of robot-assisted and open radical prostatectomy in the postdissemination era. J Clin Oncol 32:1419–1426CrossRef Gandaglia G, Sammon JD, Chang SL et al (2014) Comparative effectiveness of robot-assisted and open radical prostatectomy in the postdissemination era. J Clin Oncol 32:1419–1426CrossRef
3.
Zurück zum Zitat Kim CW, Kim CH, Baik SH (2014) Outcomes of robotic-assisted colorectal surgery compared with laparoscopic and open surgery: a systematic review. J Gastrointest Surg 18:816–830CrossRef Kim CW, Kim CH, Baik SH (2014) Outcomes of robotic-assisted colorectal surgery compared with laparoscopic and open surgery: a systematic review. J Gastrointest Surg 18:816–830CrossRef
4.
Zurück zum Zitat Martino MA, Berger EA, McFetridge JT et al (2014) A comparison of quality outcome measures in patients having a hysterectomy for benign disease: robotic vs. non-robotic approaches. J. Minimally Invas Gynecol 21:389–393CrossRef Martino MA, Berger EA, McFetridge JT et al (2014) A comparison of quality outcome measures in patients having a hysterectomy for benign disease: robotic vs. non-robotic approaches. J. Minimally Invas Gynecol 21:389–393CrossRef
5.
Zurück zum Zitat Moghadamyeghaneh Z, Hanna MH, Carmichael JC, Pigazzi A, Stamos MJ, Mills S (2016) Comparison of open, laparoscopic, and robotic approaches for total abdominal colectomy. Surg Endosc 30:2792–2798CrossRef Moghadamyeghaneh Z, Hanna MH, Carmichael JC, Pigazzi A, Stamos MJ, Mills S (2016) Comparison of open, laparoscopic, and robotic approaches for total abdominal colectomy. Surg Endosc 30:2792–2798CrossRef
6.
Zurück zum Zitat Shah CA, Beck T, Liao JB, Giannakopoulos NV, Veljovich D, Paley P (2017) Surgical and oncologic outcomes after robotic radical hysterectomy as compared to open radical hysterectomy in the treatment of early cervical cancer. J Gynecol Oncol 28:e82CrossRef Shah CA, Beck T, Liao JB, Giannakopoulos NV, Veljovich D, Paley P (2017) Surgical and oncologic outcomes after robotic radical hysterectomy as compared to open radical hysterectomy in the treatment of early cervical cancer. J Gynecol Oncol 28:e82CrossRef
7.
Zurück zum Zitat Trinh QD, Sammon J, Sun M et al (2012) Perioperative outcomes of robot-assisted radical prostatectomy compared with open radical prostatectomy: results from the nationwide inpatient sample. Eur Urol 61:679–685CrossRef Trinh QD, Sammon J, Sun M et al (2012) Perioperative outcomes of robot-assisted radical prostatectomy compared with open radical prostatectomy: results from the nationwide inpatient sample. Eur Urol 61:679–685CrossRef
8.
Zurück zum Zitat Mottrie A, Larcher A, Patel V (2018) The past, the present, and the future of robotic urology: robot-assisted surgery and human-assisted robots. Eur Urol Focus 4:629–631CrossRef Mottrie A, Larcher A, Patel V (2018) The past, the present, and the future of robotic urology: robot-assisted surgery and human-assisted robots. Eur Urol Focus 4:629–631CrossRef
9.
Zurück zum Zitat Berlinger NT (2006) Robotic surgery–squeezing into tight places. N Engl J Med 354:2099–2101CrossRef Berlinger NT (2006) Robotic surgery–squeezing into tight places. N Engl J Med 354:2099–2101CrossRef
10.
Zurück zum Zitat Aggarwal A, Lewis D, Mason M, Purushotham A, Sullivan R, van der Meulen J (2017) Effect of patient choice and hospital competition on service configuration and technology adoption within cancer surgery: a national, population-based study. Lancet Oncol 18:1445CrossRef Aggarwal A, Lewis D, Mason M, Purushotham A, Sullivan R, van der Meulen J (2017) Effect of patient choice and hospital competition on service configuration and technology adoption within cancer surgery: a national, population-based study. Lancet Oncol 18:1445CrossRef
11.
Zurück zum Zitat Mirkin JN, Lowrance WT, Feifer AH, Mulhall JP, Eastham JE, Elkin EB (2012) Direct-to-consumer Internet promotion of robotic prostatectomy exhibits varying quality of information. Health Aff (Millwood) 31:760–769CrossRef Mirkin JN, Lowrance WT, Feifer AH, Mulhall JP, Eastham JE, Elkin EB (2012) Direct-to-consumer Internet promotion of robotic prostatectomy exhibits varying quality of information. Health Aff (Millwood) 31:760–769CrossRef
12.
Zurück zum Zitat Leow JJ, Chang SL, Meyer CP et al (2016) Robot-assisted versus open radical prostatectomy: a contemporary analysis of an all-payer discharge database. Eur Urol 70:837–845CrossRef Leow JJ, Chang SL, Meyer CP et al (2016) Robot-assisted versus open radical prostatectomy: a contemporary analysis of an all-payer discharge database. Eur Urol 70:837–845CrossRef
13.
Zurück zum Zitat Jeong IG, Khandwala YS, Kim JH et al (2017) Association of robotic-assisted vs laparoscopic radical nephrectomy with perioperative outcomes and health care costs, 2003 to 2015. JAMA 318:1561–1568CrossRef Jeong IG, Khandwala YS, Kim JH et al (2017) Association of robotic-assisted vs laparoscopic radical nephrectomy with perioperative outcomes and health care costs, 2003 to 2015. JAMA 318:1561–1568CrossRef
14.
Zurück zum Zitat Lotan Y (2012) Is robotic surgery cost-effective: no. Curr Opin Urol 22:66–69CrossRef Lotan Y (2012) Is robotic surgery cost-effective: no. Curr Opin Urol 22:66–69CrossRef
15.
Zurück zum Zitat Boston-Fleischhauer C (2018) Employers as consumers of healthcare. J Nurs Adm 48:478–480CrossRef Boston-Fleischhauer C (2018) Employers as consumers of healthcare. J Nurs Adm 48:478–480CrossRef
16.
Zurück zum Zitat Epstein AJ, Groeneveld PW, Harhay MO, Yang F, Polsky D (2013) Impact of minimally invasive surgery on medical spending and employee absenteeism. JAMA Surg 148:641–647CrossRef Epstein AJ, Groeneveld PW, Harhay MO, Yang F, Polsky D (2013) Impact of minimally invasive surgery on medical spending and employee absenteeism. JAMA Surg 148:641–647CrossRef
17.
Zurück zum Zitat Childers CP, Maggard-Gibbons M (2018) Estimation of the acquisition and operating costs for robotic surgery. JAMA 320:835–836CrossRef Childers CP, Maggard-Gibbons M (2018) Estimation of the acquisition and operating costs for robotic surgery. JAMA 320:835–836CrossRef
18.
Zurück zum Zitat Juo YY, Hyder O, Haider AH, Camp M, Lidor A, Ahuja N (2014) Is minimally invasive colon resection better than traditional approaches?: First comprehensive national examination with propensity score matching. JAMA Surg 149:177–184CrossRef Juo YY, Hyder O, Haider AH, Camp M, Lidor A, Ahuja N (2014) Is minimally invasive colon resection better than traditional approaches?: First comprehensive national examination with propensity score matching. JAMA Surg 149:177–184CrossRef
19.
Zurück zum Zitat Carmichael JC, Keller DS, Baldini G et al (2017) Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons. Dis Colon Rectum 60:761–784CrossRef Carmichael JC, Keller DS, Baldini G et al (2017) Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons. Dis Colon Rectum 60:761–784CrossRef
20.
Zurück zum Zitat Abeles A, Kwasnicki RM, Darzi A (2017) Enhanced recovery after surgery: current research insights and future direction. World J Gastrointest Surg 9:37–45CrossRef Abeles A, Kwasnicki RM, Darzi A (2017) Enhanced recovery after surgery: current research insights and future direction. World J Gastrointest Surg 9:37–45CrossRef
21.
Zurück zum Zitat Ljungqvist O, Scott M, Fearon KC (2017) Enhanced recovery after surgery: a review. JAMA Surg 152:292–298CrossRef Ljungqvist O, Scott M, Fearon KC (2017) Enhanced recovery after surgery: a review. JAMA Surg 152:292–298CrossRef
22.
Zurück zum Zitat Hohwu L, Akre O, Pedersen KV, Jonsson M, Nielsen CV, Gustafsson O (2009) Open retropubic prostatectomy versus robot-assisted laparoscopic prostatectomy: a comparison of length of sick leave. Scand J Urol Nephrol 43:259–264CrossRef Hohwu L, Akre O, Pedersen KV, Jonsson M, Nielsen CV, Gustafsson O (2009) Open retropubic prostatectomy versus robot-assisted laparoscopic prostatectomy: a comparison of length of sick leave. Scand J Urol Nephrol 43:259–264CrossRef
23.
Zurück zum Zitat Billfeldt NK, Borgfeldt C, Lindkvist H, Stjerndahl JH, Ankardal M (2018) A Swedish population-based evaluation of benign hysterectomy, comparing minimally invasive and abdominal surgery. Eur J Obstet Gynecol Reprod Biol 222:113–118CrossRef Billfeldt NK, Borgfeldt C, Lindkvist H, Stjerndahl JH, Ankardal M (2018) A Swedish population-based evaluation of benign hysterectomy, comparing minimally invasive and abdominal surgery. Eur J Obstet Gynecol Reprod Biol 222:113–118CrossRef
24.
Zurück zum Zitat Borgfeldt C, Kalapotharakos G, Asciutto KC, Lofgren M, Hogberg T (2016) A population-based registry study evaluating surgery in newly diagnosed uterine cancer. Acta Obstet Gynecol Scand 95:901–911CrossRef Borgfeldt C, Kalapotharakos G, Asciutto KC, Lofgren M, Hogberg T (2016) A population-based registry study evaluating surgery in newly diagnosed uterine cancer. Acta Obstet Gynecol Scand 95:901–911CrossRef
25.
Zurück zum Zitat von Mechow S, Graefen M, Haese A et al (2018) Return to work following robot-assisted laparoscopic and open retropubic radical prostatectomy: a single-center cohort study to compare duration of sick leave. Urol Oncol 36:309.e1-e6 von Mechow S, Graefen M, Haese A et al (2018) Return to work following robot-assisted laparoscopic and open retropubic radical prostatectomy: a single-center cohort study to compare duration of sick leave. Urol Oncol 36:309.e1-e6
26.
Zurück zum Zitat Yaxley JW, Coughlin GD, Chambers SK et al (2016) Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study. Lancet (London, England) 388:1057–1066CrossRef Yaxley JW, Coughlin GD, Chambers SK et al (2016) Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study. Lancet (London, England) 388:1057–1066CrossRef
27.
Zurück zum Zitat Plym A, Chiesa F, Voss M et al (2016) Work disability after robot-assisted or open radical prostatectomy: a nationwide, population-based study. Eur Urol 70:64–71CrossRef Plym A, Chiesa F, Voss M et al (2016) Work disability after robot-assisted or open radical prostatectomy: a nationwide, population-based study. Eur Urol 70:64–71CrossRef
Metadaten
Titel
Workplace absenteeism amongst patients undergoing open vs. robotic radical prostatectomy, hysterectomy, and partial colectomy
verfasst von
Daniel Pucheril
Sean A. Fletcher
Xi Chen
David F. Friedlander
Alexander P. Cole
Marieke J. Krimphove
Adam C. Fields
Nelya Melnitchouk
Adam S. Kibel
Prokar Dasgupta
Quoc-Dien Trinh
Publikationsdatum
14.04.2020
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 4/2021
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-020-07547-y

Weitere Artikel der Ausgabe 4/2021

Surgical Endoscopy 4/2021 Zur Ausgabe

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.