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Safety in Numbers: Progressive Implementation of a Robotics Program in an Academic Surgical Oncology Practice.

Publication ,  Journal Article
King, JC; Zeh, HJ; Zureikat, AH; Celebrezze, J; Holtzman, MP; Stang, ML; Tsung, A; Bartlett, DL; Hogg, ME
Published in: Surg Innov
August 2016

Background Robotic-assisted surgery has potential benefits over laparoscopy yet little has been published on the integration of this platform into complex surgical oncology. We describe the outcomes associated with integration of robotics into a large surgical oncology program, focusing on metrics of safety and efficiency. Methods A retrospective review of a prospectively maintained database of robotic procedures from July 2009 to October 2014 identifying trends in volume, operative time, complications, conversion to open, and 90-day mortality. Results Fourteen surgeons performed 1236 cases during the study period: thyroid (246), pancreas/duodenum (458), liver (157), stomach (56), colorectal (129), adrenal (38), cholecystectomy (102), and other (48). There were 38 conversions to open (3.1%), 230 complications (18.6%), and 13 mortalities (1.1%). From 2009 to 2014, operative volume increased (7 cases/month vs 24 cases/month; P < .001) and procedure time decreased (471 ± 166 vs 211 ± 140 minutes; P < .001) with statistically significant decreases for all years except 2014 when volume and time plateaued. Conversion to open decreased (12.1% vs 1.7%; P = .009) and complications decreased (48.5% vs 12.3%; P < .001) despite increasing complexity of cases performed. There were 13 deaths within 90 days (5/13 30-day mortality) and 2 (15.4%) were from palliative surgeries. Conclusions Implementation of a diverse robotic surgical oncology program utilizing multiple surgeons is safe and feasible. As operative volume increased, operative time, complications, and conversions to open decreased and plateaued at approximately 3 years. No unanticipated adverse events attributable to the introduction of this platform were observed.

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Published In

Surg Innov

DOI

EISSN

1553-3514

Publication Date

August 2016

Volume

23

Issue

4

Start / End Page

407 / 414

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgical Oncology
  • Surgery
  • Robotic Surgical Procedures
  • Retrospective Studies
  • Postoperative Complications
  • Length of Stay
  • Humans
  • 3202 Clinical sciences
  • 1203 Design Practice and Management
 

Citation

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King, J. C., Zeh, H. J., Zureikat, A. H., Celebrezze, J., Holtzman, M. P., Stang, M. L., … Hogg, M. E. (2016). Safety in Numbers: Progressive Implementation of a Robotics Program in an Academic Surgical Oncology Practice. Surg Innov, 23(4), 407–414. https://doi.org/10.1177/1553350616646479
King, Jonathan C., Herbert J. Zeh, Amer H. Zureikat, James Celebrezze, Matthew P. Holtzman, Michael L. Stang, Allan Tsung, David L. Bartlett, and Melissa E. Hogg. “Safety in Numbers: Progressive Implementation of a Robotics Program in an Academic Surgical Oncology Practice.Surg Innov 23, no. 4 (August 2016): 407–14. https://doi.org/10.1177/1553350616646479.
King JC, Zeh HJ, Zureikat AH, Celebrezze J, Holtzman MP, Stang ML, et al. Safety in Numbers: Progressive Implementation of a Robotics Program in an Academic Surgical Oncology Practice. Surg Innov. 2016 Aug;23(4):407–14.
King, Jonathan C., et al. “Safety in Numbers: Progressive Implementation of a Robotics Program in an Academic Surgical Oncology Practice.Surg Innov, vol. 23, no. 4, Aug. 2016, pp. 407–14. Pubmed, doi:10.1177/1553350616646479.
King JC, Zeh HJ, Zureikat AH, Celebrezze J, Holtzman MP, Stang ML, Tsung A, Bartlett DL, Hogg ME. Safety in Numbers: Progressive Implementation of a Robotics Program in an Academic Surgical Oncology Practice. Surg Innov. 2016 Aug;23(4):407–414.
Journal cover image

Published In

Surg Innov

DOI

EISSN

1553-3514

Publication Date

August 2016

Volume

23

Issue

4

Start / End Page

407 / 414

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgical Oncology
  • Surgery
  • Robotic Surgical Procedures
  • Retrospective Studies
  • Postoperative Complications
  • Length of Stay
  • Humans
  • 3202 Clinical sciences
  • 1203 Design Practice and Management