[Initiating a Robotic Program for Abdominal Surgery - Experiences from a Centre in Germany]

Area of Science:

• Minimally Invasive Surgery
• Surgical Robotics
• Abdominal Surgery

Background:

• Robotic systems are increasingly utilized in abdominal surgery.
• Implementation of robotic programs requires careful planning and evaluation.

Purpose of the Study:

• To describe the implementation of a robotic surgery program in a German abdominal surgery center.
• To evaluate feasibility, safety, patient selection, learning curves, and financial aspects.

Main Methods:

• Retrospective analysis of robotic-assisted abdominal operations (August 2012 - December 2016).
• Data included demographics, perioperative parameters, oncological outcomes, and costs.
• Analysis of patient selection factors influencing outcomes and learning.

Main Results:

• 81 operations performed (colorectal, ventral mesh rectopexy, liver resections).
• Conversion rate: 7%; R0 resection achieved in all oncological cases.
• Mean hospital stay: 8.8 days; morbidity: 24% (major complications: 7%); mortality: 0%.
• Higher morbidity and longer hospitalization associated with BMI > 33.5 kg/m² and age > 65.
• Decreased operative time with increasing experience; robotic procedures were more costly than open/laparoscopic approaches.

Conclusions:

• Robotic surgery is a safe approach in abdominal procedures.
• Proper patient selection is critical, especially during program implementation.
• The learning curve and higher costs necessitate team specialization.