Fernando P Secin1, Rafael Coelho2, Juan I Monzó Gardiner3, Jose Gadú Campos Salcedo4, Roberto Puente5, Levin Martínez6, Diana Finkelstein3, Rair Valero7, Antonio León7, Daniel Angeloni8, José Rozanec9, Milton Berger10, Leandro Totti Cavazzola11, Eliney Ferreira Faria12, Roberto Días Machado12, Felipe Lott13, Franz Campos13, Jorge G Morales Montor14, Carlos Sánchez Moreno15, Hugo Dávila Barrios7. 1. Hospital Universitario CEMIC, Buenos Aires, Argentina. fsecin@yahoo.com. 2. Universidade de São Paulo, São Paulo, Brazil. 3. Hospital de Trauma Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina. 4. Hospital central militar, Mexico City, México. 5. Hospital Británico de Montevideo, Montevideo, Uruguay. 6. Hospital de Clínicas, Facultad de Medicina - Universidad de la República, Montevideo, Uruguay. 7. Hospital Universitario de Caracas, Caracas, Venezuela. 8. Hospital Escuela de Agudos Dr. Ramón Madariaga, Misiones, Argentina. 9. Hospital Británico de Buenos Aires, Buenos Aires, Argentina. 10. Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. 11. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. 12. Hospital de cáncer de Barretos, San Pablo, Brazil. 13. Brazilian National Cancer Institute, INCA, Rio do Janeiro, Brazil. 14. Hospital General Dr. Manuel Gea González, Mexico City, México. 15. Hospital Regional de Alta Especialidad de Zumpango, Zumpango de Ocampo, México.
Abstract
INTRODUCTION: There is no information about the evolution of robotic programs in public hospitals of Latin-America. OBJECTIVE: To describe the current status and functioning of robotic programs in Latin-American public hospitals since their beginning to date. METHODS: We conducted a survey among leading urologists working at public hospitals of Latin-America who had acquired the Da Vinci laparoscopic-assisted robotic system. Questions included: date the program started, its utilization by other services, number and kind of surgeries, surgery paying system, surgery related deaths, occurrence and reasons of robotic program interruptions and its use for training purposes. Medians and 25-75 centiles (IQR) were estimated. RESULTS: Since 2009, there are ten public hospitals of four Latin-American countries that acquired the Da Vinci robotic system. The median number of months robotic programs has been functioning without considering transitory interruption: 43 (IQR 35, 55). Median number of urologic and total surgeries performed: 140 (IQR 94, 168) and 336 (IQR 292, 621), respectively. The corresponding median number of urologic and total surgeries performed per month: 3 (IQR 2, 5) and 8 (IQR 5, 11). Median number of total surgeries performed per year per institution was 94 (IQR 68,123). The median proportion of urologic cases was 40% (IQR 31, 48), ranging from 24 to 66%. Five of ten institutions had their urology programs transitory or definitively closed due to the high burden costs. CONCLUSION: Adoption and development of robotic surgery in some public hospitals of Latin-America have been hindered by high costs.
INTRODUCTION: There is no information about the evolution of robotic programs in public hospitals of Latin-America. OBJECTIVE: To describe the current status and functioning of robotic programs in Latin-American public hospitals since their beginning to date. METHODS: We conducted a survey among leading urologists working at public hospitals of Latin-America who had acquired the Da Vinci laparoscopic-assisted robotic system. Questions included: date the program started, its utilization by other services, number and kind of surgeries, surgery paying system, surgery related deaths, occurrence and reasons of robotic program interruptions and its use for training purposes. Medians and 25-75 centiles (IQR) were estimated. RESULTS: Since 2009, there are ten public hospitals of four Latin-American countries that acquired the Da Vinci robotic system. The median number of months robotic programs has been functioning without considering transitory interruption: 43 (IQR 35, 55). Median number of urologic and total surgeries performed: 140 (IQR 94, 168) and 336 (IQR 292, 621), respectively. The corresponding median number of urologic and total surgeries performed per month: 3 (IQR 2, 5) and 8 (IQR 5, 11). Median number of total surgeries performed per year per institution was 94 (IQR 68,123). The median proportion of urologic cases was 40% (IQR 31, 48), ranging from 24 to 66%. Five of ten institutions had their urology programs transitory or definitively closed due to the high burden costs. CONCLUSION: Adoption and development of robotic surgery in some public hospitals of Latin-America have been hindered by high costs.
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