The total hospital cost of mitral valve repair surgery — from the time a patient is admitted to the hospital until release — is similar, whether performed through small port incisions using robotic equipment or via the conventional open-chest method, a Mayo Clinic study of 370 patients found.
Importantly, robotic surgeries were just as safe as conventional open procedures, but patients who underwent robotic mitral valve repair recovered more rapidly and returned home earlier than patients who had open-chest surgery, the study found. The results of the study also reflect systems innovation efforts designed to reduce the cost of high-technology cardiac care. The findings will be published online Oct. 1 in Mayo Clinic Proceedings.
"These results reflect an important opportunity to decrease cost and improve quality of U.S. health care when technologically complex procedures are performed by well-trained, high-volume teams capable of leveraging the potential of less invasive approaches for patient benefit," says lead author Rakesh Suri, M.D., D.Phil., a cardiovascular surgeon at Mayo Clinic in Rochester.
Patients undergo mitral valve repair surgery for severe mitral valve regurgitation, a common condition that is increasing in frequency. By 2030, an estimated 5 million Americans will have moderate to severe mitral valve regurgitation. The condition occurs when the mitral valve does not close properly, causing blood to be pumped backward instead of forward. Oxygen-rich blood is thus unable to move through the heart to the rest of the body as efficiently.
In robot-assisted cardiac operations, small incisions are made on the right side of the chest, and the surgeon conducts surgery using a robotic telemanipulator system, which includes a high-definition camera and thin mechanical arms that act as extensions of the surgeon's eyes and hands. In open-chest surgery, the surgeon cuts down the center of the chest along the breastbone to expose the heart.
"There is concern that the adoption of new technology in the operating room will increase costs," Dr. Suri says. "That does not need to be the case. While total hospital costs were slightly higher initially for robot-assisted mitral valve repair surgery, we found that with increased experience and changes in our care processes, there was a steady and significant decrease in costs over time as we progressed through the learning curve."
In this study performed between July 2007 and January 2011, 370 patients who underwent mitral valve repair surgery (185 robotically and 185 open-chest) were compared. All patients had successful surgeries and there were no early deaths. Halfway through the study period, in 2009, systems innovations were implemented, such as increased efficiency in the operating room and expedited postoperative recovery efforts that allowed patients who underwent robotic repair to have their breathing tube removed in the operating room. They also were more likely to be able to move to a hospital room the day of the surgery, decreasing the time spent in a more expensive intensive care unit.
In the pre-improvement period (before systems innovations were implemented), total cost — from admission to dismissal — for robotic surgery was slightly higher ($34,920) than for open-chest surgery ($32,650), but during the post-improvement period (after systems innovations were implemented), the median cost of robotic repair became similar to open-chest — $30,606 and $31,310, respectively.
The length of hospital stay consequently decreased in the patients who had robotic repair surgery. In the pre-systems innovation period, these patients were in the hospital for an average of four days, compared with an average of 5.6 days for open-chest patients. In the post-improvement period, the time frame was 3.7 days compared with 5.7 days, respectively.
"Studies like this one are important in health care today because they can show us that innovation can lead to reducing costs and improving patients' outcomes," says Veronique Roger, M.D., a study author and the medical director of Mayo Clinic's Center for the Science of Health Care Delivery.
The Mayo Clinic Proceedings study follows a Mayo Clinic study in The Annals of Thoracic Surgery in 2012, which found that robotic repair patients returned to work quicker than open-chest patients (33 days and 54 days, respectively). In addition, robotic repair was associated with slightly improved quality of life indicators compared with open-chest surgery during the first weeks after surgery, but indicators became indistinguishable by one year.
About Mayo Clinic
Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit MayoClinic.com or MayoClinic.org/news.
Journalists can become a member of the Mayo Clinic News Network for the latest health, science and research news and access to video, audio, text and graphic elements that can be downloaded or embedded.
NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures
17.11.2017 | National Institute of Standards and Technology (NIST)
High speed video recording precisely measures blood cell velocity
15.11.2017 | ITMO University
The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.
Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...
Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.
That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...
Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.
During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....
The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.
Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...
Pillared graphene would transfer heat better if the theoretical material had a few asymmetric junctions that caused wrinkles, according to Rice University...
15.11.2017 | Event News
15.11.2017 | Event News
30.10.2017 | Event News
17.11.2017 | Physics and Astronomy
17.11.2017 | Health and Medicine
17.11.2017 | Studies and Analyses