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J Reconstr Microsurg 2018; 34(05): 341-347
DOI: 10.1055/s-0037-1621735
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Computer-Aided Surgical Simulation in Head and Neck Reconstruction: A Cost Comparison among Traditional, In-House, and Commercial Options

Sean S. Li
1   Division of Plastic Surgery, University of California, San Diego, California
,
Libby R. Copeland-Halperin
2   Department of Surgery, Inova Fairfax, Falls Church, Virginia
,
Alexander J. Kaminsky
2   Department of Surgery, Inova Fairfax, Falls Church, Virginia
,
Jihui Li
2   Department of Surgery, Inova Fairfax, Falls Church, Virginia
,
Fahad K. Lodhi
3   School of Medicine, Virginia Commonwealth University, Richmond, Virginia
,
Reza Miraliakbari
4   Reconstructive Plastic Surgery Consultants, LLC, Fairfax, Virginia
› Author Affiliations
Further Information

Publication History

15 July 2017

19 November 2017

Publication Date:
20 February 2018 (online)

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Abstract

Background Computer-aided surgical simulation (CASS) has redefined surgery, improved precision and reduced the reliance on intraoperative trial-and-error manipulations. CASS is provided by third-party services; however, it may be cost-effective for some hospitals to develop in-house programs. This study provides the first cost analysis comparison among traditional (no CASS), commercial CASS, and in-house CASS for head and neck reconstruction.

Methods The costs of three-dimensional (3D) pre-operative planning for mandibular and maxillary reconstructions were obtained from an in-house CASS program at our large tertiary care hospital in Northern Virginia, as well as a commercial provider (Synthes, Paoli, PA). A cost comparison was performed among these modalities and extrapolated in-house CASS costs were derived. The calculations were based on estimated CASS use with cost structures similar to our institution and sunk costs were amortized over 10 years.

Results Average operating room time was estimated at 10 hours, with an average of 2 hours saved with CASS. The hourly cost to the hospital for the operating room (including anesthesia and other ancillary costs) was estimated at $4,614/hour. Per case, traditional cases were $46,140, commercial CASS cases were $40,951, and in-house CASS cases were $38,212. Annual in-house CASS costs were $39,590.

Conclusions CASS reduced operating room time, likely due to improved efficiency and accuracy. Our data demonstrate that hospitals with similar cost structure as ours, performing greater than 27 cases of 3D head and neck reconstructions per year can see a financial benefit from developing an in-house CASS program.

Keywords

CASS - VSP - head and neck

Disclosure

None.


Note

This study was presented at VASPS on November 7, 2015, NESPS on September 18, 2015, and at ASRM on January 19, 2016.