Implementation of a multidisciplinary robotic centre in a high-volume university hospital

TY - JOUR

T1 - Implementation of a multidisciplinary robotic centre in a high-volume university hospital

AU - Watt, Sara

AU - Jakobsen, Henrik Loft

AU - Vogelsang, Rasmus

AU - Kromann-Andersen, Bjarne

AU - Palle, Connie

AU - Frøding, Ligita P

AU - Dreijer, Bjørn

AU - Gögenür, Ismayil

PY - 2015/7

Y1 - 2015/7

N2 - INTRODUCTION: We describe the initiation of a multidisciplinary centre for robotic surgery including the implementation of robotic-assisted procedures as standard procedure for the majority of cancer operations in urology, gynaecology and gastrointestinal surgery. METHODS: All robotic procedures performed from 2008 to 2013 were included. The information gathered included body mass index, the American Society of Anesthesiologists’ physical status classification value (ASA), age, sex, time and type of surgery, duration of procedure, conversion to open surgery, length and type of anaesthesia, re-operations, length of hospital stay and 30-day mortality. RESULTS: The implementation strategy was to start with one specialty at a time, passing on experience from one specialty to the next. The surgical strategy was to begin with standard procedures for which international experience was available and subsequently perform more complex procedures, ending up with robotic-assisted procedures as the standard for most cancer surgery procedures. A total of 2,473 procedures were performed. The operative time was reduced over the period for the main procedures of all three specialties. For prostatectomies, hysterectomies and colectomies, conversion to open surgery occurred in 1.2, 3.8 and 7.7%; the risk of re-operation was 0.2, 2.3 and 7.3%; and, finally, the 30-day mortality was 0.1, 0 and 1%, respectively. CONCLUSION: The implementation was possible as a stepwise introduction across three specialties with low conversion and reoperation rates and a low mortality. A high-volume centre for robotic surgery was developed and patients with malignant diagnoses were offered robotic-assisted surgery within the framework of multidisciplinary cooperation. FUNDING: not relevant.

AB - INTRODUCTION: We describe the initiation of a multidisciplinary centre for robotic surgery including the implementation of robotic-assisted procedures as standard procedure for the majority of cancer operations in urology, gynaecology and gastrointestinal surgery. METHODS: All robotic procedures performed from 2008 to 2013 were included. The information gathered included body mass index, the American Society of Anesthesiologists’ physical status classification value (ASA), age, sex, time and type of surgery, duration of procedure, conversion to open surgery, length and type of anaesthesia, re-operations, length of hospital stay and 30-day mortality. RESULTS: The implementation strategy was to start with one specialty at a time, passing on experience from one specialty to the next. The surgical strategy was to begin with standard procedures for which international experience was available and subsequently perform more complex procedures, ending up with robotic-assisted procedures as the standard for most cancer surgery procedures. A total of 2,473 procedures were performed. The operative time was reduced over the period for the main procedures of all three specialties. For prostatectomies, hysterectomies and colectomies, conversion to open surgery occurred in 1.2, 3.8 and 7.7%; the risk of re-operation was 0.2, 2.3 and 7.3%; and, finally, the 30-day mortality was 0.1, 0 and 1%, respectively. CONCLUSION: The implementation was possible as a stepwise introduction across three specialties with low conversion and reoperation rates and a low mortality. A high-volume centre for robotic surgery was developed and patients with malignant diagnoses were offered robotic-assisted surgery within the framework of multidisciplinary cooperation. FUNDING: not relevant.

M3 - Journal article

SN - 2245-1919

VL - 62

SP - 1

EP - 5

JO - Danish Medical Journal

JF - Danish Medical Journal

IS - 7

M1 - A5115

ER -