CUMULATIVE REAL-WORLD ECONOMIC FOOTPRINT OF ROBOTIC-ASSISTED SURGERY ADOPTION ACROSS FOUR SWEDISH NATIONAL QUALITY REGISTRIES, 2015-2024
Author(s)
Máté Szilcz, PhD1, James Lavin, MSc2.
1Founder & CEO @Viti Science, Karolinska Institutet, Stockholm, Sweden, 2Intuitive Surgical, Aubonne, Switzerland.
1Founder & CEO @Viti Science, Karolinska Institutet, Stockholm, Sweden, 2Intuitive Surgical, Aubonne, Switzerland.
OBJECTIVES: To quantify the cumulative real-world economic footprint of robotic-assisted surgery (RAS) adoption in Sweden over a 10-year window, drawing on four national quality registries covering colon cancer, rectal cancer, benign hysterectomy, and cystectomy.
METHODS: National-level annual case counts and median clinical outcomes (length of stay, blood loss, operating time, day-surgery rate, conversion to open surgery) were extracted from each registry for 2015-2024 and harmonised into a single dataset. Analyses were conducted at the level of surgical approach (robotic-assisted versus open), consistent with registry reporting structures, to characterise real-world adoption and its resource-use consequences rather than to evaluate individual devices. Per-case incremental savings of RAS versus open surgery were computed from observed median outcome deltas and published 2024 SEK unit costs for bed-days, operating-room time, transfusion, and conversion to open surgery. Per-case savings were multiplied by annual national RAS counts and summed across 2015-2024 to obtain cumulative figures.
RESULTS: Across the four cohorts, 20,674 RAS procedures were performed (2015-2024). The pooled RAS share rose from 13.1% to 38.1% as open surgery fell from 56.7% to 22.0%. RAS volumes grew between 2.3-fold (cystectomy) and 4.9-fold (colon) over the period. Based on the clinical outcomes, per-case savings versus open surgery were 32,643 SEK (colon), 23,309 SEK (rectal), 11,687 SEK (cystectomy) and 5,909 SEK (benign hysterectomy), driven by shorter hospital stay (colorectal) and shorter operating time with reduced transfusion (cystectomy, hysterectomy). Cumulative savings reached 318.7 million SEK (≈28.8 million EUR), with annual savings rising from 17.1 million SEK in 2015 to 59.6 million SEK in 2024 (≈5.4 million EUR), a 3.5-fold increase.
CONCLUSIONS: Swedish national-registry data show that the economic case for RAS strengthens with scale, with stable per-case savings across four distinct indications and aggregate benefits that accelerated over the decade. Findings support RAS expansion as a cost-justified modernisation of high-volume surgical pathways.
METHODS: National-level annual case counts and median clinical outcomes (length of stay, blood loss, operating time, day-surgery rate, conversion to open surgery) were extracted from each registry for 2015-2024 and harmonised into a single dataset. Analyses were conducted at the level of surgical approach (robotic-assisted versus open), consistent with registry reporting structures, to characterise real-world adoption and its resource-use consequences rather than to evaluate individual devices. Per-case incremental savings of RAS versus open surgery were computed from observed median outcome deltas and published 2024 SEK unit costs for bed-days, operating-room time, transfusion, and conversion to open surgery. Per-case savings were multiplied by annual national RAS counts and summed across 2015-2024 to obtain cumulative figures.
RESULTS: Across the four cohorts, 20,674 RAS procedures were performed (2015-2024). The pooled RAS share rose from 13.1% to 38.1% as open surgery fell from 56.7% to 22.0%. RAS volumes grew between 2.3-fold (cystectomy) and 4.9-fold (colon) over the period. Based on the clinical outcomes, per-case savings versus open surgery were 32,643 SEK (colon), 23,309 SEK (rectal), 11,687 SEK (cystectomy) and 5,909 SEK (benign hysterectomy), driven by shorter hospital stay (colorectal) and shorter operating time with reduced transfusion (cystectomy, hysterectomy). Cumulative savings reached 318.7 million SEK (≈28.8 million EUR), with annual savings rising from 17.1 million SEK in 2015 to 59.6 million SEK in 2024 (≈5.4 million EUR), a 3.5-fold increase.
CONCLUSIONS: Swedish national-registry data show that the economic case for RAS strengthens with scale, with stable per-case savings across four distinct indications and aggregate benefits that accelerated over the decade. Findings support RAS expansion as a cost-justified modernisation of high-volume surgical pathways.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE268
Topic
Economic Evaluation, Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies
Disease
Surgery