20.16 The Cost of Integration of Robotic Surgery Training in the Curriculum of General Surgery Residency

M. Malekpour1, M. Fluck1, M. Alaparthi1, M. Shabahang1  1Geisinger Medical Center,Department Of General Surgery,Danville, PENNSYLVANIA, USA

Introduction:
Robotic-assisted surgery (RAS) is a newly-introduced technology with some General Surgery Residency programs recently integrating it into their curriculum. The cost-effectiveness of RAS training in general surgery residency is debated.

Methods:
All outpatient cholecystectomy cases from 2013 to 2017 were included in this study. Patients were divided into laparoscopic and robotic-assisted groups. We focused on comparison of the cost and length-of-stay (LOS) for cases based on the presence of residents.

Results:
During the 5-year study-period, 1774 cases were included. Residents were scrubbed in 70% of laparoscopic cases (1125 cases from a total of 1605 laparoscopic cholecystectomies) and 45% of robotic-assisted cases (75 cases from a total of 165 robotic-assisted cholecystectomies). Presence of residents were associated with significantly reduced costs in both laparoscopic and robotic-assisted cases (both p<0.0001). Although the presence of residents was associated with significantly longer LOSs in laparoscopic cases (12.6 vs 9.8 hours, p=0.0003), there was no association between the presence of residence and LOS in robotic-assisted cases (11.8 vs 9.6 hours, p=0.63).

Conclusion:
Presence of residence in outpatient robotic-assisted laparoscopic cholecystectomies was associated with less cost. General Surgery residency programs should consider integration of RAS in their curriculums.