Dept. of Surgery, Regional Academic Cancer Center Utrecht (RAKU), UMC Utrecht Cancer Center, Heidelberglaan 100, 3584 CX, Utrecht, G.04.228, the Netherlands.
Dept. of Surgery, Regional Academic Cancer Center Utrecht (RAKU), UMC Utrecht Cancer Center, Heidelberglaan 100, 3584 CX, Utrecht, G.04.228, the Netherlands.
HPB (Oxford). 2020 Nov;22(11):1596-1603. doi: 10.1016/j.hpb.2020.01.018. Epub 2020 Feb 21.
Aims of this study were to describe the stepwise implementation and expansion of robotic HPB surgery in a high volume HPB unit in the Netherlands and to analyze clinical outcomes of all robotic liver resections and robotic pancreatoduodenectomies performed within this program.
After proctoring by expert international surgeons, HPB surgeons were introduced to robotic liver resection and robotic pancreatoduodenectomy in a stepwise fashion. Data from two prospective databases containing all consecutive patients who underwent robotic liver resection or robotic pancreatoduodenectomy between August 1st, 2015 and March 1st, 2019 were analyzed post hoc.
In total, 77 consecutive robotic liver resections and 68 consecutive robotic pancreatoduodenectomies were performed. Five surgeons were consecutively introduced to robotic HPB surgery. Mean operative time for robotic liver resection was 160 ± 78 min. Mean operative time for robotic pancreatoduodenectomy was 420 ± 67 min. Operative times remained stable over time and were not affected by the introduction of new surgeons.
Stepwise implementation and expansion of robotic HPB surgery within one unit over a three-and-half year period is feasible and associated with good clinical outcomes. Despite introducing new surgeons to the technique, operative times, an indicator of the learning process, remained stable over time.
本研究旨在描述荷兰一家高容量肝胆外科单位逐步开展和扩大机器人肝胆手术的情况，并分析在此项目中实施的所有机器人肝切除术和机器人胰十二指肠切除术的临床结果。
在国际专家的指导下，肝胆外科医生逐步接受机器人肝切除术和机器人胰十二指肠切除术的培训。对 2015 年 8 月 1 日至 2019 年 3 月 1 日期间在两个连续前瞻性数据库中接受机器人肝切除术或机器人胰十二指肠切除术的所有连续患者的数据进行了回顾性分析。
共进行了 77 例连续机器人肝切除术和 68 例连续机器人胰十二指肠切除术。有 5 位外科医生连续接受了机器人肝胆手术的培训。机器人肝切除术的平均手术时间为 160±78 分钟。机器人胰十二指肠切除术的平均手术时间为 420±67 分钟。手术时间随时间推移保持稳定，不受新外科医生的影响。
在三年半的时间内，在一个单位内逐步开展和扩大机器人肝胆手术是可行的，并具有良好的临床效果。尽管有新的外科医生加入到该技术中，但作为学习过程指标的手术时间随时间推移保持稳定。
