Current status of robotic colorectal surgery in Australasia: A questionnaire survey of consultant members of the colorectal surgical society of Australia and New Zealand

Abstract

Background: There has been considerable interest worldwide in the application of a robotic operating platform in the practice of colorectal surgery. Objective: The aim of this study was to evaluate the current uptake of robotic colorectal surgery in Australia and New Zealand. Design: Survey data were obtained from the Colorectal Surgical Society of Australia and New Zealand (CSSANZ) registry of all specialist colorectal surgeons in Australia and New Zealand. Setting: Specialist colorectal surgeons responded to the survey through e-mail contact via an official e-mail from the CSSANZ. Materials and Methods: A questionnaire was distributed to members of the CSSANZ regarding their current robotic surgical practice. Main Outcome Measures: Volume of and nature of robotic surgery being currently undertaken in Australia and New Zealand, with an emphasis on seeking to understand the surgeon and patient factors that would promote robotic practice and also any factors or barriers in the implementation of robotic colorectal surgery being performed. Sample Size: The sample size was 77. Results: Seventy-seven replies were received from a total of 227 surveys. The response rate is similar to other comparable surveys published when the laparoscopic colorectal era was introduced. Most surgeons performed minimally invasive (laparoscopic) surgery; however, only 29% performed any robotic surgery and 50% of these performed < 5 cases in the preceding 12 months. Low rectal cancer and rectopexy surgeries were the most frequently performed robotic operations. About 48% of surgeons believed that the robotic platform offers specific patient benefits, and 75% believed that it offers specific benefits to the surgeon. The main reason for consultants not performing robotic procedures was largely related to cost, with training also cited as a barrier. Conclusion: Robotic colorectal surgery is being performed by 29% of colorectal consultants in Australasia, although only a minority of these surgeons have a substantial volume. In the future, a substantial reduction in costs is envisaged, as more companies enter the robotic surgery marketplace and competition drives reduction in costs. This in many ways mirrors the introduction of laparoscopy and we believe as cost comes down, training pathways need to be established to train the next generation of colorectal surgeons robotically. Limitations: Our study is limited by inherent limitations of survey data and the response rate.