EARLY EXPERIENCE WITH ROBOTIC SURGERY DURING COVID-19 PANDEMIA. STILL A LONG WAY TO GO! S. ROJAS, E. PASIC, E. ACOSTA, F. RAMIREZ, D. ARIZPE, HOSPITAL ANGELES PUE. MEXICO
EAES Academy. ROJAS S. 07/05/22; 363130; P175
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Abstract
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Robotic surgery has been approved and performed around the world for more than 20 years. In many countries as ours, there have been many difficulties including high cost, training and credentials for surgeons and nurses. We inform our early experience as well as all the drawbacks during this 2020 – 2021 period.
MATERIAL & METHODS: We started our training for the daVinci surgical system in simulators at the end of 2020. There were included 4 general surgeons, 1 oncology surgeon, 3 urological surgeons, 4 gynecologist surgeons. All of them practiced for a minimum of 2-3 months in order to obtain the online assessment of da Vinci/Intiuitive and the off-site training program for Console Surgeon in USA. After successfully completed the training all of them started with surgical practice in the Hospital under “proctor supervision” who has more than 50 cases/year of experience. All were consecutive cases approved by our hospital-robotic committee.
Results:
From January to September 2021, we included 50 cases: 15 in general surgery, 6 in oncology surgery, 12 in urological surgeries and 17 in gynecologic surgery. Mortality 0%, Morbility 8%, Operation time: 2-5 hrs, hospital stay: 2+/-1 days, overall cost: >30%. Convertion to open surgery: 6%.
Conclusions:
This early experience has demonstrated that robotic surgery can be performed safely in our hospital. Our group is very enthusiastic with the surgical system, and this new technology has permitted us to work as a multispecialty group. This early results are encouraging, but we have noticed the increases in overall cost, longer surgical time and not a real difference with the laparoscopic surgery performed for more than 3 decades in our practice. We are also aware of skepticism in the medical community, insurance carriers and patients. Our challenge will be in the future to demonstrate that robotic surgery is not only feasible and secure, but with experience is better than standard minimal access surgery for complex cases. Our goal will be a RCT in all surgical specialties involved to really prove the benefits for the patients.
MATERIAL & METHODS: We started our training for the daVinci surgical system in simulators at the end of 2020. There were included 4 general surgeons, 1 oncology surgeon, 3 urological surgeons, 4 gynecologist surgeons. All of them practiced for a minimum of 2-3 months in order to obtain the online assessment of da Vinci/Intiuitive and the off-site training program for Console Surgeon in USA. After successfully completed the training all of them started with surgical practice in the Hospital under “proctor supervision” who has more than 50 cases/year of experience. All were consecutive cases approved by our hospital-robotic committee.
Results:
From January to September 2021, we included 50 cases: 15 in general surgery, 6 in oncology surgery, 12 in urological surgeries and 17 in gynecologic surgery. Mortality 0%, Morbility 8%, Operation time: 2-5 hrs, hospital stay: 2+/-1 days, overall cost: >30%. Convertion to open surgery: 6%.
Conclusions:
This early experience has demonstrated that robotic surgery can be performed safely in our hospital. Our group is very enthusiastic with the surgical system, and this new technology has permitted us to work as a multispecialty group. This early results are encouraging, but we have noticed the increases in overall cost, longer surgical time and not a real difference with the laparoscopic surgery performed for more than 3 decades in our practice. We are also aware of skepticism in the medical community, insurance carriers and patients. Our challenge will be in the future to demonstrate that robotic surgery is not only feasible and secure, but with experience is better than standard minimal access surgery for complex cases. Our goal will be a RCT in all surgical specialties involved to really prove the benefits for the patients.
Robotic surgery has been approved and performed around the world for more than 20 years. In many countries as ours, there have been many difficulties including high cost, training and credentials for surgeons and nurses. We inform our early experience as well as all the drawbacks during this 2020 – 2021 period.
MATERIAL & METHODS: We started our training for the daVinci surgical system in simulators at the end of 2020. There were included 4 general surgeons, 1 oncology surgeon, 3 urological surgeons, 4 gynecologist surgeons. All of them practiced for a minimum of 2-3 months in order to obtain the online assessment of da Vinci/Intiuitive and the off-site training program for Console Surgeon in USA. After successfully completed the training all of them started with surgical practice in the Hospital under “proctor supervision” who has more than 50 cases/year of experience. All were consecutive cases approved by our hospital-robotic committee.
Results:
From January to September 2021, we included 50 cases: 15 in general surgery, 6 in oncology surgery, 12 in urological surgeries and 17 in gynecologic surgery. Mortality 0%, Morbility 8%, Operation time: 2-5 hrs, hospital stay: 2+/-1 days, overall cost: >30%. Convertion to open surgery: 6%.
Conclusions:
This early experience has demonstrated that robotic surgery can be performed safely in our hospital. Our group is very enthusiastic with the surgical system, and this new technology has permitted us to work as a multispecialty group. This early results are encouraging, but we have noticed the increases in overall cost, longer surgical time and not a real difference with the laparoscopic surgery performed for more than 3 decades in our practice. We are also aware of skepticism in the medical community, insurance carriers and patients. Our challenge will be in the future to demonstrate that robotic surgery is not only feasible and secure, but with experience is better than standard minimal access surgery for complex cases. Our goal will be a RCT in all surgical specialties involved to really prove the benefits for the patients.
MATERIAL & METHODS: We started our training for the daVinci surgical system in simulators at the end of 2020. There were included 4 general surgeons, 1 oncology surgeon, 3 urological surgeons, 4 gynecologist surgeons. All of them practiced for a minimum of 2-3 months in order to obtain the online assessment of da Vinci/Intiuitive and the off-site training program for Console Surgeon in USA. After successfully completed the training all of them started with surgical practice in the Hospital under “proctor supervision” who has more than 50 cases/year of experience. All were consecutive cases approved by our hospital-robotic committee.
Results:
From January to September 2021, we included 50 cases: 15 in general surgery, 6 in oncology surgery, 12 in urological surgeries and 17 in gynecologic surgery. Mortality 0%, Morbility 8%, Operation time: 2-5 hrs, hospital stay: 2+/-1 days, overall cost: >30%. Convertion to open surgery: 6%.
Conclusions:
This early experience has demonstrated that robotic surgery can be performed safely in our hospital. Our group is very enthusiastic with the surgical system, and this new technology has permitted us to work as a multispecialty group. This early results are encouraging, but we have noticed the increases in overall cost, longer surgical time and not a real difference with the laparoscopic surgery performed for more than 3 decades in our practice. We are also aware of skepticism in the medical community, insurance carriers and patients. Our challenge will be in the future to demonstrate that robotic surgery is not only feasible and secure, but with experience is better than standard minimal access surgery for complex cases. Our goal will be a RCT in all surgical specialties involved to really prove the benefits for the patients.
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