First 101 Robotic General Surgery Cases in a Community Hospital

Abstract

Background and Objectives:The general surgeon's robotic learning curve may improve if the experience is classified into categories based on the complexity of the procedures in a small community hospital. The intraoperative time should decrease and the incidence of complications should be comparable to conventional laparoscopy. The learning curve of a single robotic general surgeon in a small community hospital using the da Vinci S platform was analyzed.Methods:Measured parameters were operative time, console time, conversion rates, complications, surgical site infections (SSIs), surgical site occurrences (SSOs), length of stay, and patient demographics.Results:Between March 2014 and August 2015, 101 robotic general surgery cases were performed by a single surgeon in a 266-bed community hospital, including laparoscopic cholecystectomies, inguinal hernia repairs; ventral, incisional, and umbilical hernia repairs; and colorectal, foregut, bariatric, and miscellaneous procedures. Ninety-nine of the cases were completed robotically. Seven patients were readmitted within 30 days. There were 8 complications (7.92%). There were no mortalities and all complications were resolved with good outcomes. The mean operative time was 233.0 minutes. The mean console operative time was 117.6 minutes.Conclusion:A robotic general surgery program can be safely implemented in a small community hospital with extensive training of the surgical team through basic robotic skills courses as well as supplemental educational experiences. Although the use of the robotic platform in general surgery could be limited to complex procedures such as foregut and colorectal surgery, it can also be safely used in a large variety of operations with results similar to those of conventional laparoscopy.

A Case Report of a Robotic Thoracosopic Parathyroidectomy in a Community Hospital

“…To speak to this high translatability of implementing robotic surgical interventions in community hospitals, one study of 101 robotic general surgery cases in a community hospital during 2014-2015 documented 99 surgeries completed robotically with 8 complications (7.92%), with a mean operative time of 233 minutes [10]. However, there has yet to be documentation of a robotic resection of a mediastinal parathyroid adenoma in a community hospital, as this paper documents.…”

Bariatric Surgery Conversions at a Revisional Referral Center: A Subset Analysis of Clinical Outcomes from a Rural Community Hospital Accredited Program

“…However, in the rural community hospital environment, where affiliation with academic programs is less common and resources are limited, these complex procedures are not done frequently or, if they are, the outcomes have not been extensively reported. Moreover, the use of robotic technology in the rural community hospital environment and the reporting of its outcomes is another area where further clinical outcomes research is needed and where the author of this study has had extensive experience [12].…”

Robotic Ventral Hernia Repair and Endoscopic Component Separation: Outcomes

“…As discussed in a previous publication, the robotic platform can be safely instituted in a small community hospital with excellent outcome for patients. 17 …”