We were greatly interested in reviewing the letter by Dr. Daniel Botha regarding our recent case report entitled "Prehabilitation to enhance postoperative recovery for an octogenarian following robotic-assisted hysterectomy with endometrial cancer". He raises several interesting points that we expand on below. Regarding the actual direct costs of the prehabilitation intervention, it remains important to recognize that hourly fees will likely vary depending on province or territory. Even so, costs for our purposes were as follows: kinesi-ologist: nine sessions at $45 each; nutritionist: two sessions at $50 each; psychologist: two sessions at $70 each. Hence, the total cost of our intervention was approximately $650. Clearly, there are beneficial effects on functional capacity despite these costs. An important next step in determining costs includes assessing whether these improvements in patient health lead to actual cost savings through such things as reductions in length of hospitalization or burden of care required to manage postoperative delirium.
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