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Incidence of surgical site infection associated with robotic surgery
Elizabeth D Hermsen1, Tim Hinze, Harlan Sayles
1Pharmacy Relations and Clinical Decision Support, the Department of Pharmaceutical and Nutrition Care, Nebraska Medical Center, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska 68198-4031, USA. ehermsen@nebraskamed.com
Objective:
Robot-assisted surgery is minimally invasive and associated with less blood loss and shorter recovery time than open surgery. We aimed to determine the duration of robot-assisted surgical procedures and the incidence of postoperative surgical site infection (SSI) and to compare our data with the SSI incidence for open procedures according to national data.
Design:
Retrospective cohort study.
Setting:
A 689-bed academic medical center.
Patients:
All patients who underwent a surgical procedure with use of a robotic surgical system during the period from 2000-2007.
Methods:
SSIs were defined and procedure types were classified according to National Healthcare Safety Network criteria. National data for comparison were from 1992-2004. Because of small sample size, procedures were grouped according to surgical site or wound classification.
Results:
Sixteen SSIs developed after 273 robot-assisted procedures (5.9%). The mean surgical duration was 333.6 minutes. Patients who developed SSI had longer mean surgical duration than did patients who did not (558 vs 318 minutes; P<.001). The prostate and genitourinary group had 5.74 SSIs per 100 robot-assisted procedures (95% confidence interval [CI], 2.81-11.37), compared with 0.85 SSIs per 100 open procedures from national data. The gynecologic group had 10.00 SSIs per 100 procedures (95% CI, 2.79-30.10), compared with 1.72 SSIs per 100 open procedures. The colon and herniorrhaphy groups had 33.33 SSIs per 100 procedures (95% CI, 9.68-70.00) and 37.50 SSIs per 100 procedures (95% CI, 13.68-69.43), respectively, compared with 5.88 and 1.62 SSIs per 100 open procedures from national data. Patients with a clean-contaminated wound developed 6.1 SSIs per 100 procedures (95% CI, 3.5-10.3), compared with 2.59 SSIs per 100 open procedures. No significant differences in SSI rates were found for other groups.
Conclusions:
Increased incidence of SSI after some types of robot-assisted surgery compared with traditional open surgery may be related to the learning curve associated with use of the robot.
Insights
Robot-assisted surgery showed a higher incidence of surgical site infections (SSIs) in certain procedures compared to open surgery. This may be due to the learning curve associated with robotic surgical systems.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Infectious Disease
Background:
- Robot-assisted surgery offers minimally invasive benefits like reduced blood loss and faster recovery.
- However, its impact on postoperative surgical site infection (SSI) rates requires careful evaluation.
- Comparing robotic procedures to traditional open surgery is crucial for understanding safety profiles.
Purpose of the Study:
- To determine the duration of robot-assisted surgical procedures.
- To assess the incidence of postoperative surgical site infections (SSIs) following robotic surgery.
- To compare SSI rates in robot-assisted procedures with national data for open procedures.
Main Methods:
- A retrospective cohort study was conducted at a 689-bed academic medical center.
- Data included all patients undergoing robot-assisted surgery between 2000-2007.
- Surgical site infections (SSIs) and procedure types were classified using National Healthcare Safety Network criteria.
Main Results:
- The overall SSI rate was 5.9% (16 SSIs in 273 procedures).
- Prostate/genitourinary, gynecologic, colon, and herniorrhaphy procedures showed higher SSI rates compared to national open surgery data.
- Patients who developed SSIs had significantly longer surgical durations (558 vs. 318 minutes).
Conclusions:
- Certain robot-assisted procedures demonstrated an increased incidence of SSIs compared to open surgery.
- This higher SSI rate may be linked to the learning curve associated with adopting robotic surgical techniques.
- Further research is needed to optimize robotic surgery protocols and minimize infection risks.