ENVIRONMENTAL IMPACT OF IMPROVED SURGICAL OUTCOMES WITH DA VINCI ROBOTIC-ASSISTED PROSTATECTOMY IN SPAIN

Author(s)

Shanti Scheffler, PhD1, James Lavin, BS1, Roger Ndindjock, MPH2.
1Intuitive Surgical Sàrl, Aubonne, Switzerland, 2Intuitive Surgical, Madrid, Spain.
OBJECTIVES: Robotic-assisted prostatectomy has demonstrated patient benefits compared to alternative approaches of laparoscopic surgery (lap) and open surgery (open). We aimed to quantify the environmental impact of improved 30-day perioperative outcomes associated with da Vinci robotic-assisted surgery (dV-RAS) vs lap and open for radical prostatectomy cancer surgeries by estimating carbon avoidance and medical waste reduction from a national healthcare perspective in Spain.
METHODS: Employing European-specific outcome data from a sub-analysis of the COMPARE meta-analysis (which assessed dV-RAS vs lap and dV-RAS vs open) the dV-RAS improvements for length of hospital stay, 30-day readmission, blood transfusion and conversion to open (dV-RAS vs lap only) were translated to CO2 emissions (kg) and medical waste (kg) using published metrics. Carbon avoidance and medical waste analysis was scoped to the perioperative phase only, excluding intraoperative waste and broader surgical equipment lifecycle assessment.
RESULTS: During the perioperative phase, each case of dV-RAS prevents an estimated 29-100 kg of CO₂ emissions and 4-12 kg of medical waste based on length of stay, readmissions, conversion and blood transfusion reductions compared to lap and open surgical approaches, respectively. In 2024, 17,315 radical prostatectomies were performed in Spain based on national volume data. Assuming two base-case scenarios in which 100% of cases were shifted from lap and open to dV-RAS, carbon avoidance is estimated to be 499 and 1,735 metric tons, respectively. This is equivalent to driving from Madrid to Berlin and back up to 1,870 times. The reduction in medical waste disposal associated with shifting to dV-RAS is estimated to be 61-211 metric tons (with a disposal cost avoidance of up to €427,717).
CONCLUSIONS: From a national healthcare perspective in Spain, da Vinci robotic-assisted prostatectomy not only improves patient outcomes but also offers potential environmental benefits and cost savings compared to alternative surgical modalities.

Conference/Value in Health Info

2026-11, ISPOR Europe 2026, Vienna, Austria

Value in Health, Volume 29, Issue 12S

Code

CO90

Topic

Clinical Outcomes, Economic Evaluation, Medical Technologies

Topic Subcategory

Comparative Effectiveness or Efficacy

Disease

Oncology, Surgery

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