SYSTEMATIC REVIEW article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1683482
This article is part of the Research TopicReal-World Evidence and its Impact on Sustainable Health Financing, Economics and OutcomesView all 3 articles
Costs and Cost-Effectiveness of Robotic-Assisted Surgery in South Korea: A Systematic Review and Meta-Analysis
Provisionally accepted
- Health Economics and Outcomes Research, Intuitive surgical Korea, Seoul, Republic of Korea
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Introduction: Robot-assisted surgery (RAS) has rapidly expanded across multiple surgical specialties since being introduced in South Korea. RAS has been proven clinically safe and effective, but its economic implications have not been thoroughly investigated. As public reimbursement for RAS is increasingly adopted by Asian countries such as Japan and Taiwan, the economic implications of RAS have become a critical factor in influencing reimbursement decisions in Korea. Method: We conducted a systematic review and meta-analysis of studies reporting cost and cost-effectiveness of RAS in Korea, published between 2007 and March 2025. Studies were searched using three databases: PubMed, EMBASE, and Scopus. Two authors independently performed literature screening, data extraction and risk of bias assessment using ROBINS-I and RoB. Outcomes were analyzed through meta-analysis with RevMan. Results: A total of 24 were included, comprising two randomized controlled trials (RCT) and 22 observational studies. Most studies were conducted at single institutions. Colorectal surgery was the most frequently performed procedure. For RAS, total hospitalization costs ranged between $6,762 and $20,206, while laparoscopic or endoscopic surgery spanned from $3,038 to $11,933, and open surgery costs ranged from $1,706 to $9,009. The meta-analysis demonstrated that the mean difference in total hospitalization cost between RAS and laparoscopic surgery was $3,279 (95% CI: $2,414 to $4,145; I2:95%). Conclusion: This is the first comprehensive systematic review and meta-analysis specifically assessing the economic implications of RAS in Korea. Our findings indicate that RAS is more costly than other surgical modalities at the time of surgery. However, the current review identified a lack of evidence on post-discharge costs, and no full cost-effectiveness or cost-utility analyses were not available in Korea. Future studies are encouraging to explore the long-term costs across different modalities.
Keywords: Robotic assisted surgery, South Korea, Health Economics, Systematic review, Meta-analysis
Received: 11 Aug 2025; Accepted: 30 Sep 2025.
Copyright: © 2025 Hong, Shim and Shin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Minkyung Shin, minkyung.shin@intusurg.com
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