Robotic Surgery on the Rise in Emergency Procedures: Study Shows Promising Outcomes
In
a noteworthy shift in the landscape of emergency general surgery, robotic
procedures are increasingly making their mark, offering potential advantages in
outcomes, according to a comprehensive retrospective cohort study conducted
across 829 US facilities. The study states that robotic surgery which has
traditionally been associated with elective procedures, illuminates its
increasing role in emergency general surgery.
The
study results were published in the journal JAMA Surgery.
In
the realm of surgical interventions, robotic surgery has firmly established
itself as a go-to approach for a diverse array of elective operations. However,
when it comes to emergency general surgery, there exists a notable gap in
comprehensive data regarding the utility and outcomes of robotic procedures.
Hence researchers conducted a study to understand the trajectory of robotic and
laparoscopic approaches in emergency settings. Published after extensive
data analysis from July 2022 to November 2023, the study delved into the
utilization and outcomes of laparoscopic and robotic approaches for emergent
surgical procedures, focusing on cholecystectomy, colectomy, inguinal hernia repair,
and ventral hernia repair.
From
2013 to 2021, a retrospective cohort study analyzed a discharge database from
829 US facilities, covering 1,067,263 emergent surgeries. Surgical approaches
(robotic, laparoscopic, or open) were assessed for temporal trends, conversion
rates, and length of stay. Temporal trends were measured through linear
regression, and propensity score matching compared outcomes between robotic and
laparoscopic surgery groups.
Findings:
-
Over
the observed period from 2013 to 2021, robotic surgery exhibited a consistent
year-over-year increase for all examined procedures. - Notable percentages
included a 0.7% rise for cholecystectomy, 0.9% for colectomy, 1.9% for inguinal
hernia repair, and 1.1% for ventral hernia repair. -
This
trend was accompanied by a corresponding decrease in the conventional open
surgical approach across the board.
Robotic
surgery was associated with a significantly lower risk of conversion to open
surgery in all four procedures.- For instance, in cholecystectomy, the
conversion risk was 1.7% for robotic surgery compared to 3.0% for laparoscopy. -
Similar
trends were observed in colectomy, inguinal hernia repair, and ventral hernia
repair, with robotic surgery consistently demonstrating lower conversion rates.
Furthermore,
the study revealed a notable advantage in postoperative lengths of stay for
patients undergoing robotic surgery.-
Specifically,
colectomy, inguinal hernia repair, and ventral hernia repair displayed shorter
stays for the robotic surgery cohort. -
The
reduced length of stay suggests a potential improvement in recovery times and
resource utilization, marking a positive development for both patients and
healthcare systems.
While
the adoption of robotic surgery in emergency settings is not yet ubiquitous,
the study underscores a growing trend and suggests promising outcomes
associated with this advanced approach. As technological advancements continue
to shape the field of surgery, the increasing prevalence of robotics in
emergency procedures holds the potential to enhance patient outcomes and
redefine standards in emergency general surgery. The findings provide valuable
insights for the medical community, paving the way for further exploration of
the role of robotics in emergency settings.
Further reading: Lunardi N, Abou-Zamzam A, Florecki KL, et al. Robotic Technology in Emergency General Surgery Cases in the Era of Minimally Invasive Surgery. JAMA Surg. Published online March 06, 2024. doi:10.1001/jamasurg.2024.0016