Abstract：
Robotic surgery with Da Vinci has revolutionized the treatment of several diseases, including prostate cancer; nevertheless, costs remain the major drawback. Recently, new robotic platforms entered the market aiming to reduce costs and improve the access to robotic surgery. The aim of the study is to compare direct cost for initial hospital stay of radical prostatectomy performed with two different robotic systems, the Da Vinci and the new Hugo RAS system. This is a projection study that applies cost of robotic surgery, derived from a local tender, to the clinical course of robotic radical prostatectomy (RALP) performed with Da Vinci and Hugo RAS. The study was performed in a public referral center for robotic surgery equipped with both systems. The cost of robotic surgery from a local tender were considered and included rent, annual maintenance, and a per-procedure fee covering the setup of four robotic instruments. Those costs were applied to patients who underwent RALP with both systems since November 2022. The primary endpoint is to evaluate direct costs of initial hospital stay for Da Vinci and Hugo RAS, by considering equipment costs (as derived from the tender), and costs of theater and of hospitalization. The direct per-procedure cost is €2,246.31 for a Da Vinci procedure and €1995 for a Hugo RALP. In the local setting, Hugo RAS provides 11% of cost saving for RALP. By applying this per-procedure cost to our clinical data, the expenditure for the entire index hospitalization is € 6.7755,1 for Da Vinci and € 6.637,15 for Hugo RALP. The new Hugo RAS system is willing to reduce direct expenditures of robotic surgery for RALP; furthermore, it provides similar peri-operative outcomes compared to the Da Vinci. However, other drivers of costs should be taken into account, such as the duration of OR use-that is more than just console time and may depend on the facility\'s background and organization. Further variations in direct costs of robotic systems are related to caseload, local agreements and negotiations. Thus, cost comparison of new robotic platform still remains an ongoing issue.
摘要：
达芬奇的机器人手术彻底改变了几种疾病的治疗方法，包括前列腺癌；尽管如此，成本仍然是主要的缺点。最近,新的机器人平台进入市场，旨在降低成本并改善机器人手术的获取。该研究的目的是比较使用两种不同的机器人系统进行根治性前列腺切除术的初始住院时间的直接费用。达芬奇和新的雨果RAS系统。这是一项应用机器人手术成本的预测研究，源自当地招标，达芬奇和雨果RAS进行机器人根治性前列腺切除术（RALP）的临床过程。这项研究是在配备两种系统的公共机器人手术转诊中心进行的。考虑了当地招标的机器人手术费用，其中包括租金，年度维护,和每个程序的费用，包括四个机器人仪器的设置。这些费用适用于自2022年11月以来接受两种系统RALP的患者。主要终点是评估达芬奇和雨果RAS的初始住院直接费用，通过考虑设备成本(从投标中得出)，以及剧院和住院费用。达芬奇手术的直接每道程序费用为2,246.31欧元，雨果RALP为1995欧元。在本地设置中，HugoRAS为RALP节省了11%的成本。通过将每个程序的成本应用于我们的临床数据，达芬奇的整个指数住院支出为6.7555,1欧元，雨果RALP为6.637,15欧元。新的HugoRAS系统愿意减少RALP机器人手术的直接支出;此外，与达芬奇相比,它提供了相似的围手术期结局.然而,应考虑其他成本驱动因素，例如或使用的持续时间-这不仅仅是控制台时间，可能取决于设施的背景和组织。机器人系统的直接成本的进一步变化与案件量有关，地方协议和谈判。因此，新机器人平台的成本比较仍然是一个持续存在的问题。
