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Revista de la Asociación Médica del Centro Médico ABC

2018, Number 4

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An Med Asoc Med Hosp ABC 2018; 63 (4)

Robotic surgery in the ABC Medical Center: creation of the robotic committee and initial 200-case experience

Vásquez LC, Decanini TC, Maffuz-Aziz A, Alfaro AJ, Huante PJA

Language: Spanish
References: 37
Page: 312 - 316
PDF size: 194.36 Kb.


ABSTRACT

Introduction: Robotic surgery is a technological advance used in multiple surgical specialties worldwide. A vast range of literature supports the benefits of robotic surgery over laparoscopic and open surgery. Objective: To document the initial experience in a private hospital of the use of robotic surgery in different surgical areas. We analyzed the data regarding results and complications. Material and methods: We included the first 200 robotic surgeries in our hospital in a 15-month period, documenting the specialty and the number of physicians involved, the type of surgery performed, the surgical time and complications. Results: Of the 200 patients, 138 (69%) were male and 62 (31%) female. The three most frequent surgeries performed were radical prostatectomy (107), hysterectomy (32) and inguinal repair (13). The average age was 55.1 years (range: from 27 to 76 years). A total of 22 certified surgeons from five specialties performed the total number of surgeries. Conclusions: Robotic surgery is a well-established tool and has demonstrated benefits over open and laparoscopic surgery regarding results and complication rates. There are several implications in starting a robotic program in a private hospital. The creation of a robotic committee formed by physicians certified in robotic surgery and hospital authorities has helped in the certification process of its staff, keeping the program safe in regards of the expertise of its surgical staff and the type of procedures performed, and therefore, lowering the complication rate and obtaining better surgical results.


REFERENCES

  1. Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR. Laparoscopic radical prostatectomy: initial short-term experience. Urology. 1997; 50 (6): 854-857.

  2. Brinkman W, de Angst I, Schreuder H, Schout B, Draaisma W, Verweij L et al. Current training on the basics of robotic surgery in the Netherlands: Time for a multidisciplinary approach? Surg Endosc. 2017; 31 (1): 281-287.

  3. Farivar BS, Flannagan M, Leitman IM. General surgery residents’ perception of robot-assisted procedures during surgical training. J Surg Educ. 2015; 72 (2): 235-242.

  4. Ahlering TE, Woo D, Eichel L, Lee DI, Edwards R, Skarecky DW. Robot-assisted versus open radical prostatectomy: a comparison of one surgeon’s outcomes. Urology. 2004; 63 (5): 819-822.

  5. Kim B, Chang A, Kaswick J, Derboghossians A, Jung H, Slezak J et al. Achieving proficiency with robot-assisted radical prostatectomy: Laparoscopic-trained versus robotics-trained surgeons. Can Urol Assoc J. 2013; 7 (11-12): E711-E715.

  6. Moore BW, Dolat ME, McPartlin D, Mayer Grob B, Guruli G, Hampton LJ. Establishment of a new robotic prostatectomy program at a tertiary Veteran’s Affairs medical center. J Robot Surg. 2013; 7 (2): 171-175.

  7. Hu JC, Gu X, Lipsitz SR, Barry MJ, D’Amico AV, Weinberg AC et al. Comparative effectiveness of minimally invasive vs open radical prostatectomy. JAMA. 2009; 302 (14): 1557-1564.

  8. Coelho RF, Rocco B, Patel MB, Orvieto MA, Chauhan S, Ficarra V et al. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a critical review of outcomes reported by high-volume centers. J Endourol. 2010; 24 (12): 2003-2015.

  9. Nelson B, Kaufman M, Broughton G, Cookson MS, Chang SS, Herrell SD et al. Comparison of length of hospital stay between radical retropubic prostatectomy and robotic assisted laparoscopic prostatectomy. J Urol. 2007; 177 (3): 929-931.

  10. Chan F. Robotic-assisted surgical procedures are the future of gynaecology in Australasia. Aust N Z J Obstet Gynaecol. 2018; 58 (3): 371-374.

  11. Gomes MTV, Costa-Porto BTD, Parise-Filho JP, Vasconcelos AL, Bottura BF, Marques RM. Safety model for the introduction of robotic surgery in gynecology. Rev Bras Ginecol Obstet. 2018; 40 (7): 397-402.

  12. Zanagnolo V, Achilarre MT, Maruccio M, Garbi A. Might robotic-assisted surgery become commonplace in endometrial cancer treatment? Expert Rev Anticancer Ther. 2018; 18 (6): 507-509.

  13. Kosturakis AK, LaRusso KE, Carroll ND, Nicholl MB. First 100 consecutive robotic inguinal hernia repairs at a Veterans Affairs hospital. J Robot Surg. 2018; 12 (4): 699-704.

  14. Edelman DS. Robotic inguinal hernia repair. Am Surg. 2017; 83 (12): 1418-1421.

  15. Arcerito M, Changchien E, Bernal O, Konkoly-Thege A, Moon J. Robotic inguinal hernia repair: technique and early experience. Am Surg. 2016; 82 (10): 1014-1017.

  16. Mitropoulos D, Artibani W, Graefen M, Remzi M, Rouprêt M, Truss M et al. Reporting and grading of complications after urologic surgical procedures: an ad-hoc EAU guidelines panel assessment and recommendations. Eur Urol. 2012; 61 (2): 341-349.

  17. Tsao AK, Smaldone MD, Averch TD, Jackman SV. Robot-assisted laparoscopic prostatectomy: the first 100 patients-improving patient safety and outcomes. J Endourol. 2009; 23 (3): 481-484.

  18. Kwon EO, Bautista TC, Blumberg JM, Jung H, Tamaddon K, Aboseif SR et al. Rapid implementation of a robot-assisted prostatectomy program in a large health maintenance organization setting. J Endourol. 2010; 24 (3): 461-465.

  19. Box GN, Ahlering TE. Robotic radical prostatectomy: long-term outcomes. Curr Opin Urol. 2008; 18 (2): 173-179.

  20. Yip SKh, Sim HG. Robotic radical prostatectomy in east Asia: development, surgical results and challenges. Curr Opin Urol. 2010; 20 (1): 80-85.

  21. Bolenz C, Gupta A, Hotze T, Ho R, Cadeddu JA, Roehrborn CG et al. Cost comparison of robotic, laparoscopic, and open radical prostatectomy for prostate cancer. Eur Urol. 2010; 57 (3): 453-458.

  22. Rocco B, Lorusso A, Coelho RF, Palmer KJ, Patel VR. Building a robotic program. Scand J Surg. 2009; 98 (2): 72-75.

  23. Steinberg PL, Merguerian PA, Bihrle W 3rd, Seigne JD. The cost of learning robotic-assisted prostatectomy. Urology. 2008; 72 (5): 1068-1072.

  24. Longo WE, Cheadle W, Fink A, Kozol R, DePalma R, Rege R et al. The role of the Veterans Affairs Medical Centers in patient care, surgical education, research and faculty development. Am J Surg. 2005; 190 (5): 662-675.

  25. Link BA, Nelson R, Josephson DY, Lau C, Wilson TG. Training of urologic oncology fellows does not adversely impact outcomes of robot-assisted laparoscopic prostatectomy. J Endourol. 2009; 23 (2): 301-305.

  26. Laviana AA, Hu JC. A comparison of the robotic-assisted versus retropubic radical prostatectomy. Minerva Urol Nefrol. 2013; 65 (3): 161-170.

  27. Desai GS. Robotic surgery: is it right for India? J Robot Surg. 2018; 12 (4): 725-726.

  28. Lauterbach R, Matanes E, Lowenstein L. Review of robotic surgery in gynecology-the future is here. Rambam Maimonides Med J. 2017; 8 (2). doi: 10.5041/RMMJ.10296.

  29. Truong M, Kim JH, Scheib S, Patzkowsky K. Advantages of robotics in benign gynecologic surgery. Curr Opin Obstet Gynecol. 2016; 28 (4): 304-310.

  30. Heidenreich A, Bellmunt J, Bolla M, Joniau S, Mason M, Matveev V et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol. 2011; 59 (1): 61-71.

  31. Trinh QD, Sammon J, Sun M, Ravi P, Ghani KR, Bianchi M et al. Perioperative outcomes of robot-assisted radical prostatectomy compared with open radical prostatectomy: results from the nationwide inpatient sample. Eur Urol. 2012; 61 (4): 679-685.

  32. Tewari A, Sooriakumaran P, Bloch DA, Seshadri-Kreaden U, Hebert AE, Wiklund P. Positive surgical margin and perioperative complication rates of primary surgical treatments for prostate cancer: a systematic review and meta-analysis comparing retropubic, laparoscopic, and robotic prostatectomy. Eur Urol. 2012; 62 (1): 1-15.

  33. Gandaglia G, Sammon JD, Chang SL, Choueiri TK, Hu JC, Karakiewicz PI et al. Comparative effectiveness of robot-assisted and open radical prostatectomy in the postdissemination era. J Clin Oncol. 2014; 32 (14): 1419-1426.

  34. Novara G, Ficarra V, Rosen RC, Artibani W, Costello A, Eastham JA et al. Systematic review and meta-analysis of perioperative outcomes and complications after robot-assisted radical prostatectomy. Eur Urol. 2012; 62 (3): 431-452.

  35. Borahay MA, Tapısız ÖL, Alanbay İ, Kılıç GS. Outcomes of robotic, laparoscopic, and open hysterectomy for benign conditions in obese patients. J Turk Ger Gynecol Assoc. 2018; 19 (2): 72-77.

  36. Gali B, Bakkum-Gamez JN, Plevak DJ, Schroeder D, Wilson TO, Jankowski CJ. Perioperative outcomes of robotic-assisted hysterectomy compared with open hysterectomy. Anesth Analg. 2018; 126 (1): 127-133.

  37. Jung M, Morel P, Buehler L, Buchs NC, Hagen ME. Robotic general surgery: current practice, evidence, and perspective. Langenbecks Arch Surg. 2015; 400 (3): 283-292.




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