Elizabeth D Hermsen1, Tim Hinze, Harlan Sayles, Lee Sholtz, Mark E Rupp. 1. Pharmacy Relations and Clinical Decision Support, the Department of Pharmaceutical and Nutrition Care, Nebraska Medical Center, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska 68198-4031, USA. ehermsen@nebraskamed.com
Abstract
OBJECTIVE: Robot-assisted surgery is minimally invasive and associated with less blood loss and shorter recovery time than open surgery. We aimed to determine the duration of robot-assisted surgical procedures and the incidence of postoperative surgical site infection (SSI) and to compare our data with the SSI incidence for open procedures according to national data. DESIGN: Retrospective cohort study. SETTING: A 689-bed academic medical center. PATIENTS: All patients who underwent a surgical procedure with use of a robotic surgical system during the period from 2000-2007. METHODS: SSIs were defined and procedure types were classified according to National Healthcare Safety Network criteria. National data for comparison were from 1992-2004. Because of small sample size, procedures were grouped according to surgical site or wound classification. RESULTS: Sixteen SSIs developed after 273 robot-assisted procedures (5.9%). The mean surgical duration was 333.6 minutes. Patients who developed SSI had longer mean surgical duration than did patients who did not (558 vs 318 minutes; P<.001). The prostate and genitourinary group had 5.74 SSIs per 100 robot-assisted procedures (95% confidence interval [CI], 2.81-11.37), compared with 0.85 SSIs per 100 open procedures from national data. The gynecologic group had 10.00 SSIs per 100 procedures (95% CI, 2.79-30.10), compared with 1.72 SSIs per 100 open procedures. The colon and herniorrhaphy groups had 33.33 SSIs per 100 procedures (95% CI, 9.68-70.00) and 37.50 SSIs per 100 procedures (95% CI, 13.68-69.43), respectively, compared with 5.88 and 1.62 SSIs per 100 open procedures from national data. Patients with a clean-contaminated wound developed 6.1 SSIs per 100 procedures (95% CI, 3.5-10.3), compared with 2.59 SSIs per 100 open procedures. No significant differences in SSI rates were found for other groups. CONCLUSIONS: Increased incidence of SSI after some types of robot-assisted surgery compared with traditional open surgery may be related to the learning curve associated with use of the robot.
OBJECTIVE: Robot-assisted surgery is minimally invasive and associated with less blood loss and shorter recovery time than open surgery. We aimed to determine the duration of robot-assisted surgical procedures and the incidence of postoperative surgical site infection (SSI) and to compare our data with the SSI incidence for open procedures according to national data. DESIGN: Retrospective cohort study. SETTING: A 689-bed academic medical center. PATIENTS: All patients who underwent a surgical procedure with use of a robotic surgical system during the period from 2000-2007. METHODS: SSIs were defined and procedure types were classified according to National Healthcare Safety Network criteria. National data for comparison were from 1992-2004. Because of small sample size, procedures were grouped according to surgical site or wound classification. RESULTS: Sixteen SSIs developed after 273 robot-assisted procedures (5.9%). The mean surgical duration was 333.6 minutes. Patients who developed SSI had longer mean surgical duration than did patients who did not (558 vs 318 minutes; P<.001). The prostate and genitourinary group had 5.74 SSIs per 100 robot-assisted procedures (95% confidence interval [CI], 2.81-11.37), compared with 0.85 SSIs per 100 open procedures from national data. The gynecologic group had 10.00 SSIs per 100 procedures (95% CI, 2.79-30.10), compared with 1.72 SSIs per 100 open procedures. The colon and herniorrhaphy groups had 33.33 SSIs per 100 procedures (95% CI, 9.68-70.00) and 37.50 SSIs per 100 procedures (95% CI, 13.68-69.43), respectively, compared with 5.88 and 1.62 SSIs per 100 open procedures from national data. Patients with a clean-contaminated wound developed 6.1 SSIs per 100 procedures (95% CI, 3.5-10.3), compared with 2.59 SSIs per 100 open procedures. No significant differences in SSI rates were found for other groups. CONCLUSIONS: Increased incidence of SSI after some types of robot-assisted surgery compared with traditional open surgery may be related to the learning curve associated with use of the robot.
Authors: Julian Hanske; Alejandro Sanchez; Marianne Schmid; Christian P Meyer; Firas Abdollah; Florian Roghmann; Adam S Feldman; Adam S Kibel; Jesse D Sammon; Joachim Noldus; Quoc-Dien Trinh; Jairam R Eswara Journal: World J Urol Date: 2015-05-13 Impact factor: 4.226
Authors: Jacopo Adolfo Rossi de Vermandois; Giovanni Cochetti; Michele Del Zingaro; Alberto Santoro; Mattia Panciarola; Andrea Boni; Matteo Marsico; Gianluca Gaudio; Alessio Paladini; Paolo Guiggi; Roberto Cirocchi; Ettore Mearini Journal: Open Med (Wars) Date: 2019-09-15