Shinder Brian M, Farber Nicholas J, Weiss Robert E, Jang Thomas L, Kim Isaac Y, Singer Eric A, Elsamra Sammy E
Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
Robot Surg. 2017;4:87-91. doi: 10.2147/RSRR.S135713. Epub 2017 Aug 17.
This article aimed to assess the burden of scheduling major urologic oncology procedures if all cases were performed robotically and to determine whether this would increase the time a patient would have to wait for surgery. We retrospectively determined the number of prostatectomies, radical nephrectomies, partial nephrectomies, and cystectomies at a single institution for one calendar year. A hypothetical situation was then constructed where all procedures were performed robotically. Using the allotted number of days that each surgeon was able to schedule robotic procedures, we analyzed the amount of time it would take to schedule and complete all cases. Five fellowship-trained surgeons were included in the study and accounted for 317 surgical cases. Three of the surgeons had dedicated robotic surgery (RS) time (block time), while two surgeons scheduled when there was non-dedicated RS time (open time) available. If all cases were performed robotically an additional 32 days would be needed, which could significantly increase the wait time to surgery. The limited number of robotic systems available in most hospitals creates a bottleneck effect; whereby increasing the number of cases would considerably lengthen the waiting time patients have for surgery. As RS becomes increasingly more commonplace in urology and other surgical fields, this could create a significant problem for health care systems.
本文旨在评估如果所有病例都通过机器人手术进行,安排主要泌尿外科肿瘤手术的负担,并确定这是否会增加患者等待手术的时间。我们回顾性地确定了一家机构在一个日历年中前列腺切除术、根治性肾切除术、部分肾切除术和膀胱切除术的数量。然后构建了一种假设情况,即所有手术都通过机器人进行。利用每位外科医生能够安排机器人手术的指定天数,我们分析了安排和完成所有病例所需的时间。该研究纳入了五位经过专科培训的外科医生,他们共完成了317例手术。其中三位外科医生有专门的机器人手术(RS)时间(整块时间),而另外两位外科医生在有非专门的RS时间(空闲时间)时进行安排。如果所有病例都通过机器人进行,将需要额外的32天,这可能会显著增加手术等待时间。大多数医院可用的机器人系统数量有限会产生瓶颈效应;即增加病例数量会大幅延长患者的手术等待时间。随着机器人手术在泌尿外科和其他外科领域越来越普遍,这可能会给医疗系统带来重大问题。