POTENTIAL ENVIRONMENTAL AND ECONOMIC IMPLICATIONS OF ROBOTIC ASSISTED SURGERY FOR UROLOGIC ONCOLOGY
Author(s)
Don Hoeler, MHA, FACHE1, Kyle Tafuri, MBA2;
1Intuitive Surgical, Director Health Policy Implementation Sciences, Portland, OR, USA, 2Hackensack Meridian Health, Hackensack, NJ, USA
1Intuitive Surgical, Director Health Policy Implementation Sciences, Portland, OR, USA, 2Hackensack Meridian Health, Hackensack, NJ, USA
OBJECTIVES: To assess the potential environmental and associated economic implications of robotic-assisted surgery compared with open and laparoscopic approaches for prostatectomy and partial nephrectomy procedures with primary focus on medical waste generation and disposal costs, secondarily assessing carbon emissions with hospital resource utilization.
METHODS: De-identified electronic medical record data from 708 robotic-assisted surgery urologic procedures performed in 2022 were analyzed and benchmarked against a published laparoscopic and open surgery cohorts. Clinical outcomes available included length of hospital stay, 30-day readmission and blood transfusion rates. Medical waste generation and carbon emissions were modeled using published conversion figures linking inpatient outcomes to environmental impact. Economic outcomes were then estimated based on waste disposal costs. A scenario analysis estimated the minimum and maximum effect sizes at the system level for waste, disposable costs, and carbon emissions by surgical modality.
RESULTS: Relative to open and laparoscopic benchmarks, robotic-assisted surgery was associated with reduced hospital resource utilization which was translated to avoid 12-24 kilograms of medical waste per procedure with medical disposal costs ranging between $19,000 - $31,000 on an annual basis. At the health system level, this creates a meaningful annual reduction in medical waste volume and associated costs with disposing of that waste across the evaluated procedures and modalities. Reduced inpatient utilization also was associated with modeled carbon avoidance of 70-100 metric tons of carbon dioxide per year. Scenario analysis demonstrated consistent waste, cost, and carbon reductions across all modeled baseline.
CONCLUSIONS: Evaluating medical waste generation and costs throughout perioperative outcomes should be assessed in any environmental and cost assessments. These findings suggest that robotic-assisted surgery may support environmental and economic performance through reducing resource use and downstream waste generation in patient care areas like the general ward. Incorporating waste and carbon related outcomes could help inform policy decisions, economic and sustainability strategies.
METHODS: De-identified electronic medical record data from 708 robotic-assisted surgery urologic procedures performed in 2022 were analyzed and benchmarked against a published laparoscopic and open surgery cohorts. Clinical outcomes available included length of hospital stay, 30-day readmission and blood transfusion rates. Medical waste generation and carbon emissions were modeled using published conversion figures linking inpatient outcomes to environmental impact. Economic outcomes were then estimated based on waste disposal costs. A scenario analysis estimated the minimum and maximum effect sizes at the system level for waste, disposable costs, and carbon emissions by surgical modality.
RESULTS: Relative to open and laparoscopic benchmarks, robotic-assisted surgery was associated with reduced hospital resource utilization which was translated to avoid 12-24 kilograms of medical waste per procedure with medical disposal costs ranging between $19,000 - $31,000 on an annual basis. At the health system level, this creates a meaningful annual reduction in medical waste volume and associated costs with disposing of that waste across the evaluated procedures and modalities. Reduced inpatient utilization also was associated with modeled carbon avoidance of 70-100 metric tons of carbon dioxide per year. Scenario analysis demonstrated consistent waste, cost, and carbon reductions across all modeled baseline.
CONCLUSIONS: Evaluating medical waste generation and costs throughout perioperative outcomes should be assessed in any environmental and cost assessments. These findings suggest that robotic-assisted surgery may support environmental and economic performance through reducing resource use and downstream waste generation in patient care areas like the general ward. Incorporating waste and carbon related outcomes could help inform policy decisions, economic and sustainability strategies.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
P52
Topic
Economic Evaluation
Topic Subcategory
Novel & Social Elements of Value
Disease
SDC: Oncology, SDC: Urinary/Kidney Disorders