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德国对经口机器人手术的接受和采用。

Acceptance and adoption of transoral robotic surgery in Germany.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Asklepios Hospital St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.

出版信息

Eur Arch Otorhinolaryngol. 2021 Oct;278(10):4021-4026. doi: 10.1007/s00405-021-06623-w. Epub 2021 Feb 7.

Abstract

PURPOSE

Since its introduction over a decade ago, the use of robotic surgery (RS) in head and neck surgery has widely spread around the globe, with very differential adoption of this novel surgical technique in different parts of the world. In this study, we analyze the acceptance and adoption of robotic surgery in the head and neck in Germany.

MATERIALS AND METHODS

A cross-sectional analysis using a questionnaire evaluating the acceptance and adoption of RS was performed. Questionnaires were distributed to all chairmen /-women of Otorhinolaryngology, Head and Neck Surgery Departments in Germany.

RESULTS

A total of 107 respondents completed the questionnaire (65.2%). At university hospitals, 71.4% of the respondents indicated that a robotic system was available, and 21.4% responded that robotic surgery was performed at their institution; 22.7% and 0.04%, respectively, at non-university hospitals. The overall adoption rate was 0.8%. The most common cases performed were TORS resection in the oropharynx. Main reasons for not adopting this technique were costs, lack of interest and available co-operations.

CONCLUSION

This study provides evidence of the extent of adoption of TORS in Germany; main perceived barriers to adoption are costs with lack of cost-covering reimbursement and insufficient co-operations with other disciplines as well as hospital administration resulting in a very low adoption rate of this technique over the past decade. Results from this study may assist in decision-making processes on adopting this technique in the future.

摘要

目的

自十多年前引入以来,机器人手术(RS)在头颈部手术中的应用已在全球范围内广泛传播,但在世界不同地区对这种新型手术技术的采用程度存在很大差异。本研究分析了德国头颈部机器人手术的接受度和采用情况。

材料与方法

使用评估 RS 接受度和采用情况的问卷进行了横断面分析。问卷分发给德国耳鼻喉科头颈外科系的所有主席/副主席。

结果

共有 107 名受访者完成了问卷(65.2%)。在大学医院,71.4%的受访者表示有机器人系统,21.4%的受访者表示他们所在机构开展了机器人手术;而非大学医院的这一比例分别为 22.7%和 0.04%。总体采用率为 0.8%。最常进行的手术是口咽 TORS 切除术。不采用该技术的主要原因是成本、缺乏兴趣和可用的合作。

结论

本研究提供了德国 TORS 采用程度的证据;采用该技术的主要障碍是成本,包括缺乏成本覆盖的报销以及与其他学科以及医院管理的合作不足,导致过去十年该技术的采用率非常低。本研究的结果可能有助于未来在采用该技术方面的决策过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3444/8382611/01a80b715331/405_2021_6623_Fig1_HTML.jpg

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