腹腔鏡手術ロボット「Dexter®」のIDEAL準拠の実装：包括的なフレームワークと臨床的成果

The integration of advanced technologies is transforming surgical practice, particularly through robotic systems. This study presents the early clinical implementation of the Dexter^® surgical robot for cholecystectomy and evaluates clinical outcomes using the IDEAL framework.

Twenty patients underwent elective robotic-assisted cholecystectomy using the Dexter^® robot. A thorough implementation process, including rigorous surgeon and nurse training and standardized care protocols, was established. Data on operative metrics, complications, and patient outcomes were analyzed, and patient well-being was assessed via a postoperative phone survey.

Six surgeons and thirty nurses were trained, with surgeons completing a minimum of 20 h of simulation. Preoperative and operative times were significantly reduced through this process. Comparing the first 10 operations to the second, docking time decreased from 11.4 ± 4.1 min to 7.1 ± 2.1 min (p=0.0144) and operative time improved from 130.5 ± 25.7 min to 99.7 ± 21.8 min (p=0.0134). Mean intraoperative blood loss was minimal, averaging 19.5 ± 31.4 mL, and the average length of hospital stay was 3.1 ± 1.4 days. Postoperative pain levels were low, and patient satisfaction was high, as assessed by telephone survey.

Our findings highlight the value of the IDEAL framework in guiding the systematic evaluation and implementation of new surgical technologies such as the Dexter^® robot. A structured approach is essential to improve patient outcomes and safety in the coming digital transformation of surgery.