Hansen D L, Christophersen C, Fonnes S, Rosenberg J
Centre for Perioperative Optimisation, Department of Surgery, Herlev and Gentofte Hospitals, University of Copenhagen, Herlev, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.
Hernia. 2022 Dec;26(6):1653-1658. doi: 10.1007/s10029-022-02691-x. Epub 2022 Oct 6.
Robot-assisted groin hernia repair is becoming more popular in recent years but may remove operations from surgical trainees. We aimed to investigate the educational level of the surgeons who performed robot-assisted groin hernia repair and the rate of supervision and compare this to open and laparoscopic groin hernia repair.
This register-based study was reported according to the RECORD statement and used linked data from the Danish Hernia Database and the Danish Patient Safety Authority's Online Register. We included surgeons that performed robot-assisted, laparoscopic, and/or open groin hernia repairs performed between January 1, 2015, and June 15, 2021 in Denmark.
A total of 916 surgeons performing 43,856 groin hernia repairs were included in this study. Surgical specialists performed 98% of the robot-assisted groin hernia repairs, 89% of the laparoscopic repairs (p < 0.0001), and 54% of the Lichtenstein repairs (p < 0.0001). Only 5% of the robot-assisted groin hernia repairs were supervised compared with 11% of the laparoscopic repairs (p < 0.0001) and 28% of the open repairs (p < 0.0001).
Almost all groin hernia repairs performed with the robot-assisted technique were performed by surgeons specialized in general surgery. The proportions of surgeons specialized in surgery were higher for robot-assisted operations compared with laparoscopic or open groin hernia surgery. Thus, our data suggest a lack of involvement of surgeons in training, and this diminishes the educational potential in the pool of groin hernia operations by the use of robot-assisted repairs.
近年来，机器人辅助腹股沟疝修补术越来越受欢迎，但可能会使外科实习生无法参与手术操作。我们旨在调查实施机器人辅助腹股沟疝修补术的外科医生的教育水平和监督率，并将其与开放和腹腔镜腹股沟疝修补术进行比较。
本基于登记的研究根据RECORD声明进行报告，并使用了丹麦疝数据库和丹麦患者安全管理局在线登记处的关联数据。我们纳入了2015年1月1日至2021年6月15日期间在丹麦实施机器人辅助、腹腔镜和/或开放腹股沟疝修补术的外科医生。
本研究共纳入916名实施43856例腹股沟疝修补术的外科医生。外科专科医生实施了98%的机器人辅助腹股沟疝修补术、89%的腹腔镜修补术（p＜0.0001）和54%的利chtenstein修补术（p＜0.0001）。只有5%的机器人辅助腹股沟疝修补术受到监督，而腹腔镜修补术为11%（p＜0.0001），开放修补术为28%（p＜0.0001）。
几乎所有采用机器人辅助技术进行的腹股沟疝修补术均由普通外科专科医生实施。与腹腔镜或开放腹股沟疝手术相比，机器人辅助手术中专科外科医生的比例更高。因此，我们的数据表明缺乏外科培训医生的参与，这降低了使用机器人辅助修补术在腹股沟疝手术中的教育潜力。
