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质量而非数量——波兰机器人手术当前面临的挑战

Quality over quantity-current challenges of robotic surgery in Poland.

作者信息

Kubiak Marcin, Doniec Jacek, Grasso S Vincent, Gumbs Andrew, Mohammadi Amir Nour, Sędłak Katarzyna, Pelc Zuzanna, Góźdź Stanisław, Załuska Wojciech, Bachta Artur, Rybojad Paweł, Torres Kamil, Pawlik Timothy M, Zawadzki Marek, Budzyński Andrzej, Rawicz-Pruszyński Karol

机构信息

Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland.

Robotic Surgery Center, Military Institute of Medicine - National Research Institute, Warsaw, Poland.

出版信息

J Robot Surg. 2025 Jun 3;19(1):258. doi: 10.1007/s11701-025-02423-0.

Abstract

Since its introduction in 2010, a dynamic growth of robotic-assisted surgery (RAS) has been observed in Poland. The number of healthcare institutions implementing RAS has tripled in the last 36 months, with 80 surgical robots currently utilized on a national scale. While urological procedures dominate RAS utilization (73%), adoption in gynecology (12.2%) and gastrointestinal surgery (8.5%) is rising, driven by recent National Health Fund reimbursement policies. However, significant fragmentation and alarmingly low numbers of individual RAS procedures were identified: 47.7% of surgeons perform less than 40 cases annually. Parallel to expanding the robotic surgery reimbursement program, several standardized actions are warranted to further facilitate and optimize modern surgical practices in Poland. Regional disparities in access and underutilization of robotic systems, followed by a lack of a centralized and standardized registry to evaluate surgical and oncological outcomes, represent the main challenges to integrating robotic surgery nationally. Addressing these, followed by implementing structured training and uniform evaluation frameworks for clinical and oncological outcomes, are critical to maximizing the potential of surgical robotic systems in Poland.

摘要

自2010年引入以来,波兰的机器人辅助手术(RAS)呈现出动态增长。在过去36个月里,实施RAS的医疗机构数量增加了两倍,目前全国范围内使用了80台手术机器人。虽然泌尿外科手术在RAS的使用中占主导地位(73%),但在国家卫生基金最近的报销政策推动下,妇科(12.2%)和胃肠外科(8.5%)的应用正在增加。然而,发现存在严重的分散性以及个别RAS手术数量低得惊人的情况:47.7%的外科医生每年进行的手术病例不到40例。在扩大机器人手术报销计划的同时,有必要采取若干标准化行动,以进一步促进和优化波兰的现代外科手术实践。机器人系统在获取和利用方面的地区差异,以及缺乏用于评估手术和肿瘤学结果的集中标准化登记系统,是在全国范围内整合机器人手术的主要挑战。解决这些问题,随后为临床和肿瘤学结果实施结构化培训和统一评估框架,对于在波兰充分发挥手术机器人系统的潜力至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/480a/12133999/fd13c59d4334/11701_2025_2423_Fig1_HTML.jpg

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