Economic Assessment of STarting Endoscopic Robotic Groin Hernia Repair

Study Overview
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Brief Summary
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The material cost for robotic groin hernia repair is higher than for conventional laparoscopic surgery. In this study, this amount will be quantified and possible differences in early postoperative course, hospital stay and readmission rate that could influence the cost/benefit ratio for robotic groin hernia surgery will be analyzed.

Detailed Description
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Robot-assisted groin hernia repair has been introduced in AZ Maria Middelares hospital since September 2016. In these procedures, the daVinci robot is being used to perform minimal invasive repair of these hernias. At the moment, this technique is frequently being used for groin hernia repair. Literature shows a clear benefit of robot-assisted versus open repair. Hospital stay decreases and complications are less frequently observed in patients who underwent minimal invasive repair (Henriksen NA et al., 2018). On the other hand, the benefits of robot-assisted repair are less obvious compared to conventional laparoscopy. Many robot-trained surgeons are in favor of robot-assisted repair, but current literature is still inconclusive about the economic feasibility of robot-assisted groin hernia repair as standard of care. This retrospective observational study is primarily designed to analyze the additional cost of robot-assisted groin hernia repair compared to conventional laparoscopic repair. A cost-benefit analysis will be carried out for groin hernia repairs performed by the same surgeon (Dr. Filip Muysoms) in the period 2016-2019. As primary endpoint, direct costs related to the introduction of robot-assisted groin hernia repair will be analyzed. These are: material costs, costs related to hospital stay, honoraria and costs related to intrahospital complications. A comparison will be made between conventional laparoscopic and robot-assisted groin hernia repair. As secondary endpoint, indirect costs will be compared between both groups. These include costs related to late complications and readmissions related to the index operation.

Official Title
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Retrospective Comparative Study on Costs of Conventional Versus Robotic Assisted Laparoscopic Groin Hernia Repair

Conditions
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Inguinal Hernia

Intervention / Treatment
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* Procedure: Robot-assisted hernia repair


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adult patients underwent uni-or bilateral groin hernia repair in the period 2015- 2019 surgery through minimal invasive repair Exclusion Criteria: open surgery or conversion from minimal-invasive to open surgery combined procedures age below 18 years

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Robot-assisted laparoscopy<br>Patients who underwent robot-assisted groin hernia repair | Procedure: Robot-assisted hernia repair<br>* Inguinal hernia repair was performed using the DaVinci Xi robotic system<br>|
| Conventional laparoscopy<br>Patients who underwent conventional laparoscopic groin hernia repair | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Direct costs | Material costs, hospitalization costs, specialist fees and costs related to early complications | Immediately post hospital discharge | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Indirect costs | Late complication costs, readmission costs | 0- 42 days postoperatively |