Trends in Route of Hysterectomy after the Implementation of a Comprehensive Robotic Training Program.

IF 1.3 Q3 SURGERY
Minimally Invasive Surgery Pub Date : 2018-09-17 eCollection Date: 2018-01-01 DOI:10.1155/2018/7362489
Eleni Papalekas, Jay Fisher
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引用次数: 14

Abstract

Objective: To evaluate trends in surgical approach for hysterectomy following the introduction and implementation of a comprehensive robotic surgery program.

Methods: A retrospective review of all hysterectomies done at two institutions, a community hospital and a suburban, tertiary-care teaching hospital, in the same health system over a five-year period, January 2010 through December 2014. A robotic surgery training program was implemented during the first year of the study and trends in route of hysterectomy were evaluated in the subsequent years.

Results: A total of 5175 patients undergoing hysterectomy, for both benign and malignant indications, were included in the study. There was a significant decrease in the percent of cases performed through an abdominal approach at both the community and teaching hospitals (19.3% decline at each institution). There was an inversely related significant increase in the percent of robotic procedures at both the community and teaching hospitals (44.5% and 17%, respectively). A decrease in number of cases performed vaginally over this period was only noted in the community hospital site (25.2% decrease), and there was a slightly higher rate of vaginal hysterectomies at the teaching hospital over this study period (21.9% in 2010, 24.1% in 2014).

Conclusion: The decrease in number of abdominal and laparoscopic hysterectomies and increase in number of robotic hysterectomies that was seen are consistent with national trends. The initiation of a robotic training program did not prevent the proliferation of use of the robot but did aim to ensure proficiency on the robot prior to gaining privileges for patient use. This type of comprehensive training and monitoring program could be applied to future technologic advances to ensure a standard level of surgical proficiency. Trends in route of hysterectomy are clearly multifactorial and involve patient, provider, and location-specific factors that are likely to continue to change.

Abstract Image

Abstract Image

综合机器人训练计划实施后子宫切除术路径的趋势。
目的:评价综合机器人手术方案引入和实施后子宫切除术手术入路的趋势。方法:回顾性分析2010年1月至2014年12月在同一卫生系统的两家机构,一家社区医院和一家郊区三级保健教学医院进行的所有子宫切除术。在研究的第一年实施了机器人手术培训计划,并在随后的几年中评估了子宫切除术路线的趋势。结果:本研究共纳入5175例子宫切除术患者,包括良性和恶性适应症。在社区医院和教学医院,通过腹部手术的病例百分比显著下降(每家机构下降19.3%)。在社区医院和教学医院,机器人手术的比例呈负相关的显著增加(分别为44.5%和17%)。在此期间,只有社区医院的阴道手术例数有所下降(下降25.2%),而教学医院的阴道子宫切除术率在此研究期间略高(2010年21.9%,2014年24.1%)。结论:腹部和腹腔镜子宫切除术数量的减少和机器人子宫切除术数量的增加与全国趋势一致。机器人训练计划的启动并没有阻止机器人使用的扩散,但确实旨在确保在获得患者使用特权之前对机器人的熟练程度。这种类型的综合培训和监测计划可以应用于未来的技术进步,以确保手术熟练程度的标准水平。子宫切除术路径的趋势显然是多因素的,涉及患者、提供者和特定地点的因素,这些因素可能会继续改变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.00
自引率
0.00%
发文量
8
审稿时长
16 weeks
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