Lung volume reduction surgery: a micro-costing analysis from a national tertiary referral centre.

This article focuses on a micro-costing analysis comparing three lung volume reduction surgery (LVRS) modalities—endobronchial valve insertion (EBV-LVRS), video-assisted thoracic surgery (VATS-LVRS), and robot-assisted thoracic surgery (RATS-LVRS)—used to treat patients with chronic obstructive pulmonary disease (COPD). The study found that VATS-LVRS incurred the lowest mean hospital cost per patient (€12,896), followed by RATS-LVRS (€13,305) and EBV-LVRS (€15,598), with higher EBV-LVRS costs largely driven by consumables and complication-related revisions. The costing model, based on data from a high-volume thoracic center in Ireland, includes staff, consumables, capital, postoperative, and complication costs over a 90-day postoperative period. This framework offers healthcare providers and commissioners a tool to evaluate resource use and cost drivers in LVRS service provision, though limitations include retrospective data for RATS-LVRS and assumptions of similar clinical outcomes across modalities.