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
