{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:29:13Z","timestamp":1793039353183,"version":"4.5.0"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The use of robotic surgery has expanded rapidly; however, its cost-effectiveness in foregut surgery remains unclear. We aimed to compare early postoperative outcomes and procedure-related costs between robotic (R-) and laparoscopic (L-) antireflux surgery (ARS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort and cost-effectiveness study was conducted using a prospectively maintained database of adults who underwent minimally invasive ARS by a single experienced esophageal surgeon. All primary elective R-ARS cases (September 2016\u2013December 2024) were identified, and perioperative outcomes and procedure costs (US$) were compared to a 1:1 propensity-score matched L-ARS cohort. Moreover, incremental cost-effectiveness ratios (ICERs) were calculated for predefined outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 138 patients (69 R-ARS, 69 L-ARS) were included. R-ARS was associated with a longer median operating room utilization time (169 vs 128\u00a0min.,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and length-of-stay (2 vs. 1\u00a0days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045) and slightly more intraoperative complications (5.8 vs. 1.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.362). Early complications (10.1% both), ICU admissions (R-ARS, 2.9% vs. L-ARS, 1.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.999), and 90-day readmissions (R-ARS, 6.1% vs. L-ARS, 3.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.749) were similar between the groups. The median all-inclusive cost was higher with R-ARS ($15,676.1 vs. $7694.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Although the incidence of patient-reported postoperative dysphagia was similar after R-ARS or L-ARS (26.1 vs. 30.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.705), resulting endoscopic interventions were more frequent after R-ARS (16\/18 [88.9%] vs. 9\/21 [42.9%],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). The ICERs for intraoperative complications and 90-day readmissions were \u2013$181,390.9 (favoring L-ARS) and $285,042.9 (favoring R-ARS), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Overall, R-ARS may not offer superior short-term safety compared to L-ARS, utilizes greater resources, and appears to be less cost-effective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-025-12551-1","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T17:32:43Z","timestamp":1768930363000},"page":"2967-2975","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Laparoscopic vs. robotic-assisted antireflux surgery: a matched cohort analysis of procedure costs and outcomes"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3401-8623","authenticated-orcid":false,"given":"Andr\u00e9s R.","family":"Latorre-Rodr\u00edguez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8681-968X","authenticated-orcid":false,"given":"Arianna","family":"Vittori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2216-9109","authenticated-orcid":false,"given":"Ross M.","family":"Bremner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2760-3891","authenticated-orcid":false,"given":"Sumeet K.","family":"Mittal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"12551_CR1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1166\/ajrs.2014.1006","volume":"1","author":"J Shah","year":"2014","unstructured":"Shah J, Vyas A, Vyas D (2014) The history of robotics in surgical specialties. 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Latorre-Rodr\u00edguez: has served as a consultant for Medtronic Inc. and Castle Biosciences Inc. Arianna Vittori: has served as a consultant for Castle Biosciences Inc. Sumeet K. Mittal: has served as consultant for Medtronic Inc., Endostim LLC, and Attract LLC. None of these relations influenced the study or the reporting of findings. Ross M. Bremner has no potential conflicts to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}