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Cost Comparison of Hand Assisted (HALPN) vs Robotic Assisted Laparoscopic Partial Nephrectomy (RALPN)
Sammy E Elsamra, Andrew Leone, Michael Lasser, Simone Thavaseelan, George Haleblian, Gyan Pareek
Warren Alpert Medical School of Brown University, Providence, RI

Introduction: While many studies tout the benefits of RALPN, none have evaluated the financial cost of this approach. Herein, we evaluate the financial cost of RALPN as compared to HALPN at our institution.

Materials & Methods: The records of all HALPN and RALPN between 2006 and 2010 were reviewed. Total cost of each procedure was based on operative room cost (time cost of room, anesthesia time cost, and supply) and hospital stay cost. These costs were applied to the mean HALPN and RALPN patient (Table 1).
Results: 47 patients underwent HALPN and 21 patients underwent RALPN. Room time and operative time were significantly shorter for the HALPN cohort whereas LOS was significantly shorter in the RALPN cohort. The decreased LOS led to a cost savings of \ for the RALPN cohort. The increased time in the OR led to an increased cost of \ (OR time fee and anesthesia fee). Further, the cost of surgical supplies was \ greater for the RALPN. There is an overall savings of \ if HALPN is selected (Figure 1).
Conclusions:
HALPN is significantly less expensive than RALPN and should be considered for its financial value.

Comparison of OR Times and LOS for HALPN vs RALPN
HALPNRALPNp-value
Number of Cases4319
Surgery Time (min)150221<0.01
Room Time (min)203275<0.01
Length of Stay (days)4.23.5<0.02


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