Eren Esen, MD, Erman Aytac, MD, Ilknur Erenler Bayraktar, MD, Bilgi Baca, MD, Ismail Hamzaoglu, MD, Tayfun Karahasanoglu, MD. Department of General Surgery, Acibadem Mehmet Ali Aydinlar University School of Medicine
Introduction: Robotic techniques have been developed to facilitate application of minimally invasive techniques and to overcome limitations of laparoscopy. While robotic surgery has been performed almost for two decades, data about the trends and adoption of robots in colorectal practice is scarce. This study aimed to show implementation of robotic technology in colorectal surgery.
Methods: Patients underwent robotic surgery between the beginning of 2013 to first half of 2017 in Turkey were included. Data were obtained from a prospectively maintained database. Patient, surgeon and hospital identifiers were encrypted. Parameters were operation type, operation year, robotic system used (S, Si, Xi), hospital volume and surgeon volume. High volume robotic colorectal hospital and surgeon was defined as the caseload within the forth interquartile (75th -100th) based on the median value.
Results: There were 799 colorectal procedures. 47 surgeons performed robotic colorectal surgery at 25 hospitals. 341(42.7%) and 458(57.3%) procedures were performed with the S-Si and Xi platforms respectively. 2 hospitals have both of the Si and Xi platforms. 4 hospitals are the Si, 8 hospitals are the Xi hospital currently. The number of robotic colorectal operations increased gradually by years (Figure 1). The median numbers of colorectal procedures were 13(range 1-171) and 5(range 1-151) per hospital and per surgeon respectively. There were 12 high volume (≥23 cases) robotic colorectal surgeons (HVRCS). There were 6 high volume (≥40 cases) robotic colorectal hospitals (HVRCH). HVRCS performed 644 (81%) of the all cases. Among those HVRCS, the numbers of Si and Xi users were 7 and 5 respectively. The surgeons who performed more than 11 procedures continued to use robot in their practice except one surgeon who stopped at 27. Only 2 left colectomies and no right colonic resection were performed before introduction of the Xi platform.
Conclusions: Robotic practice in the field of colorectal surgery has been going towards monopolization which seems reasonable to achieve better outcomes by increasing caseload per hospital/surgeon. Majority of the surgeons abandoned robotic practice without reaching baseline learning curve levels.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87919
Program Number: P772
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster