Multicenter retrospective study of the first robotic surgeries in selected Brazilian centers

Advances in robotics have established the surgical modality approach as gold standard for several procedures. The aim of this study was to present a demographic analysis of the first robotic surgeries performed in selected Brazilian centers over a 5-year period, with insights on the evolution of this technology.

This retrospective cohort study analyzed data from 16 Brazilian hospitals equipped with robotic platforms between 2016 and 2020. Surgical procedures were evaluated according to specialty, primary surgeon, presence of a proctor, operating room time, console time, hospital, and year of performance. Surgeon experience was estimated based on time since medical graduation and categorized. Statistical analysis was performed using Generalized Equations.

A total of 4,363 surgeries were analyzed, with 80% performed in São Paulo state. General surgery, urology, and gynecology accounted for most procedures. A progressive reduction in console time was observed over the years, considering procedures in general, specific procedure time-trend analysis and within high-volume surgeons, but no statistical evidence was drawn and findings are exploratory. This study is limited by its retrospective design, lack of standardized data regarding individual training pathways, and absence of clinical outcome measures. Therefore, it is a descriptive audit of case volumes and operative times, without interpretation of surgical quality or patient safety.

Robotic surgery has expanded rapidly in Brazil, with concentration in the Southeast region. Procedural volume and structured training are primary factors associated with improved performance. Early integration of robotic surgery into surgical education may optimize learning curves and surgeon proficiency.