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.
Resolving the mystery of preeclampsia
21.10.2016 | Universitätsklinikum Magdeburg
New potential cancer treatment using microwaves to target deep tumors
12.10.2016 | University of Texas at Arlington
Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.
"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...
In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.
A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...
By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.
"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...
COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.
In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...
'Ferroelectric' materials can switch between different states of electrical polarization in response to an external electric field. This flexibility means they show promise for many applications, for example in electronic devices and computer memory. Current ferroelectric materials are highly valued for their thermal and chemical stability and rapid electro-mechanical responses, but creating a material that is scalable down to the tiny sizes needed for technologies like silicon-based semiconductors (Si-based CMOS) has proven challenging.
Now, Hiroshi Funakubo and co-workers at the Tokyo Institute of Technology, in collaboration with researchers across Japan, have conducted experiments to...
14.10.2016 | Event News
14.10.2016 | Event News
12.10.2016 | Event News
21.10.2016 | Health and Medicine
21.10.2016 | Information Technology
21.10.2016 | Materials Sciences