The goal is to compare clinical outcomes, hospital costs, and cost-utility in patients undergoing anatomical lung resections with DaVinci Xi vs Versius platforms The main questions it aims to answer are: * Do patients that undergo an anatomical lung resection with DaVinci Xi have the same clinical outcomes (complications, stay...) than those who were operated with Versius? * Are anatomical lung resections performed with DaVinci Xi more expensive than those performed with Versius? * Are anatomical lung resection performed with DaVinci Xi more cost-effective than those performed with Versius? Participants already undergoing robotic anatomical lung resection as part of their regular medical care will answer quality of life questionnaires preoperatively, at 1, 3, 6, and 12 months after surgery.
Study Type
OBSERVATIONAL
Enrollment
150
Robotic platform used to perform anatomical lung resection (lobectomy or segmentectomy)
Robotic platform used to perform anatomical lung resection (lobectomy or segmentectomy)
Hospital Universitario Ramón y Cajal
Madrid, Madrid, Spain
Cost/utility ratio
The cost/utility ratio will be calculated as the incremental cost per quality-adjusted life year (QALY) gained, comparing robotic-assisted thoracic surgery (RATS) with Da Vinci Xi and Versius. Costs will include all direct procedural costs (including consumables, reusable instruments, operating room time, and maintenance costs of equipment), as well as postoperative hospital-related costs. Health outcomes will be expressed in QALYs, derived from validated health-related quality of life measures collected during follow-up. The analysis will be conducted from the healthcare system perspective, and results will be expressed as an incremental cost-effectiveness ratio (ICER).\*
Time frame: Data will be collected preoperatively (baseline), at 1, 3, 6, and 12 months after surgery.
Operation time
Operation time will be defined as the duration of the surgical procedure, measured in minutes from skin incision to skin closure. This variable will be compared between Da Vinci Xi and Versius
Time frame: Perioperative/periprocedural
Conversions
Conversion rate will be defined as the need to convert from RATS to VATS or open thoracotomy during the procedure. The proportion of conversions will be recorded and compared between groups.
Time frame: Perioperative/periprocedural
Complications
Postoperative complications will be defined as any adverse events occurring within 30 days after surgery. Complications will be recorded prospectively and classified according to a standardized grading system (e.g., Clavien-Dindo classification). Both overall complication rates and severity grades will be analyzed and compared between groups.
Time frame: Within 30 days after surgery
Lymph nodes yielded
Lymph node yield will be defined as the total number of lymph nodes resected and retrieved during surgery, as reported in the pathological examination. This variable will be used as a surrogate of oncological quality and compared between Da Vinci and Versius groups.
Time frame: Perioperative/periprocedural
Total cost
Total cost will include all direct hospital-related costs associated with the procedure and postoperative care. This encompasses consumables, reusable equipment (with cost allocation), operating room time, hospital stay, and any costs derived from complications or readmissions.
Time frame: In-hospital (from the day of operation until the day of discharge)
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