A robotic surgery program in general surgery without access to robotic simulator: A single center experience

Objective : Robotic surgery has been extensively advocated worldwide, representing a revolution in the surgical field. To facilitate the advantages of robotic surgery, meticulous preparation and step-by-step training are important for the safe and successful implementation of a robotic surgery program. Surgeons should acquire new technical skills to use all aspects of the platform best. In this report, we describe our experience and technical development during the first year following the launch of our robotic program. We present our experience planning and implementing a successful robotic program in a general surgery department at a peripheral hospital without access to a robotic simulator. Design : We describe the training of our first robotic team and two subsequent teams during the first year of the robotic program. Setting : All cases involving robotic surgery at our institution throughout 2023 were considered eligible for inclusion and retrospectively analyzed. Participants : Overall, 186 robotic surgeries were performed in 2023. The most common surgeries were cholecystectomy (37.1%) and inguinal hernia repair (29.6%). Results : Since the onset of the robotic program, many measures of surgical performance improved. For cholecystectomy, operative time decreased from 90 to 30 minutes, and console time decreased from 65 to 25 minutes. For inguinal hernia repair, operative time decreased from 120 to 39 minutes, and console time decreased from 80 to 34 minutes. After the first 10 cases, we began performing cholecystectomy and inguinal hernia repair using only two robotic instruments. Moreover, robotic cholecystectomy was 17% cheaper than laparoscopic surgery. Notably, no patients developed major complications. Conclusion : Building a robotic program begins with mental preparation, followed by meticulously planned technical training conducted on the robotic console, ensuring a successful and safe program. Our robotic surgical program delivered high surgical performance.