Current status and evolution of robotic-assisted thoracic surgery in Germany-results from a nationwide survey.
Germany
Thoracic surgery
robotic-assisted thoracic surgery (RATS)
robotics
Journal
Journal of thoracic disease
ISSN: 2072-1439
Titre abrégé: J Thorac Dis
Pays: China
ID NLM: 101533916
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
entrez:
7
1
2020
pubmed:
7
1
2020
medline:
7
1
2020
Statut:
ppublish
Résumé
Robot-assisted surgery has made a significant entry into surgical practice within Germany, including thoracic surgery. As no published data exists regarding robotic-assisted thoracic surgery (RATS), we conducted a survey to investigate its current status. We performed a nationwide survey of all centers active in RATS, using a standardized questionnaire. The annual number of operations, mean duration of surgery, docking time, length of hospital stay(s), conversions, chest tube duration, the RATS program start date, robot system used, operating room capacity, and staplers and instruments used were recorded. Of the 22 centers contacted, 14 responded. In total, 786 RATS interventions were recorded. Most were anatomical lung resections, comprising 372 (bi-) lobectomies and 80 segmentectomies. During the study period, eight bronchoplastic procedures were performed robotically. There were 93 wedge lung resections, 148 thymectomies, 26 sympathectomies, and 59 other RATS procedures, and a single-center series of around 1,000 RATS thymectomies (excluded from statistical analysis). The average incision-suture time of the RATS lobectomy was 245 (range, 80-419) minutes, average residence time seven days. The conversion rate was 6.7% across all interventions, with significant inter-intervention differences. All surveyed centers plan to further expand RATS, with OR capacity being a frequent impediment. Five RATS interventions were performed in Germany in 2013, versus 320 in 2018. Overall, RATS is becoming more established in everyday clinical practice in Germany. The number of operations, active centers, and trained RATS surgeons has increased steadily since 2013. A German-speaking operation course for entry into RATS already exists. Even extended resections can be carried out safely, and RATS has become standard procedure in some centers.
Sections du résumé
BACKGROUND
BACKGROUND
Robot-assisted surgery has made a significant entry into surgical practice within Germany, including thoracic surgery. As no published data exists regarding robotic-assisted thoracic surgery (RATS), we conducted a survey to investigate its current status.
METHODS
METHODS
We performed a nationwide survey of all centers active in RATS, using a standardized questionnaire. The annual number of operations, mean duration of surgery, docking time, length of hospital stay(s), conversions, chest tube duration, the RATS program start date, robot system used, operating room capacity, and staplers and instruments used were recorded.
RESULTS
RESULTS
Of the 22 centers contacted, 14 responded. In total, 786 RATS interventions were recorded. Most were anatomical lung resections, comprising 372 (bi-) lobectomies and 80 segmentectomies. During the study period, eight bronchoplastic procedures were performed robotically. There were 93 wedge lung resections, 148 thymectomies, 26 sympathectomies, and 59 other RATS procedures, and a single-center series of around 1,000 RATS thymectomies (excluded from statistical analysis). The average incision-suture time of the RATS lobectomy was 245 (range, 80-419) minutes, average residence time seven days. The conversion rate was 6.7% across all interventions, with significant inter-intervention differences. All surveyed centers plan to further expand RATS, with OR capacity being a frequent impediment. Five RATS interventions were performed in Germany in 2013, versus 320 in 2018.
CONCLUSIONS
CONCLUSIONS
Overall, RATS is becoming more established in everyday clinical practice in Germany. The number of operations, active centers, and trained RATS surgeons has increased steadily since 2013. A German-speaking operation course for entry into RATS already exists. Even extended resections can be carried out safely, and RATS has become standard procedure in some centers.
Identifiants
pubmed: 31903271
doi: 10.21037/jtd.2019.10.48
pii: jtd-11-11-4807
pmc: PMC6940261
doi:
Types de publication
Journal Article
Langues
eng
Pagination
4807-4815Informations de copyright
2019 Journal of Thoracic Disease. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: JH Egberts, JC Rückert are working as a proctor for intuitive. The other authors have no conflicts of interest to declare.
Références
Ann Thorac Surg. 2016 Sep;102(3):917-924
pubmed: 27209613
Langenbecks Arch Surg. 2016 Sep;401(6):877-84
pubmed: 27448662
J Am Coll Surg. 2018 Jun;226(6):1052-1062.e15
pubmed: 29574177
Urology. 2016 Sep;95:5-10
pubmed: 27211930
J Cardiovasc Surg (Torino). 2019 Aug;60(4):526-531
pubmed: 30916521
Innovations (Phila). 2018 Nov/Dec;13(6):417-422
pubmed: 30516571
J Clin Oncol. 2007 Nov 1;25(31):4993-7
pubmed: 17971599
J Thorac Cardiovasc Surg. 2014 Mar;147(3):929-37
pubmed: 24210834
J Thorac Cardiovasc Surg. 2011 Oct;142(4):740-6
pubmed: 21840547
Ann Surg. 2017 Feb;265(2):431-437
pubmed: 28059973
J Robot Surg. 2016 Mar;10(1):57-61
pubmed: 26559538
Ann Thorac Surg. 2013 Feb;95(2):426-32
pubmed: 23219257
Thorac Cardiovasc Surg. 2019 Oct;67(7):603-605
pubmed: 29908525
J Thorac Dis. 2014 Jul;6(7):937-42
pubmed: 25093090
Ann Thorac Surg. 2013 Sep;96(3):943-9; discussion 949-50
pubmed: 23684159
World J Surg Oncol. 2017 May 8;15(1):98
pubmed: 28482928
Ann Thorac Surg. 2010 May;89(5):1563-70
pubmed: 20417778
Thorac Cardiovasc Surg. 2019 Oct;67(7):573-577
pubmed: 29625502
J Robot Surg. 2015 Mar;9(1):67-73
pubmed: 26530974
Zentralbl Chir. 2013 Oct;138 Suppl 1:S40-4
pubmed: 24150854
Ann Thorac Surg. 2014 Jan;97(1):236-42; discussion 242-4
pubmed: 24090577
Ann Thorac Surg. 2012 Aug;94(2):347-53; discussion 353
pubmed: 22742843
Surg Laparosc Endosc. 1992 Sep;2(3):244-7
pubmed: 1341539
Chirurg. 2015 Jul;86(7):711-21
pubmed: 26104735
Eur J Cardiothorac Surg. 2002 May;21(5):864-8
pubmed: 12062276
Eur Urol. 2014 Dec;66(6):1033-43
pubmed: 25041850
Ann Thorac Surg. 2012 May;93(5):1598-604; discussion 1604-5
pubmed: 22440364
J Thorac Cardiovasc Surg. 2012 Feb;143(2):383-9
pubmed: 22104677
Chirurg. 2016 Aug;87(8):669-75
pubmed: 27324496
Ann Thorac Surg. 2014 Jun;97(6):1901-6; discussion 1906-7
pubmed: 24726603