Abstract
PurposeSince its introduction over a decade ago, the use of robotic surgery (RS) in head and neck surgery has widely spread around the globe, with very differential adoption of this novel surgical technique in different parts of the world. In this study, we analyze the acceptance and adoption of robotic surgery in the head and neck in Germany.Materials and methodsA cross-sectional analysis using a questionnaire evaluating the acceptance and adoption of RS was performed. Questionnaires were distributed to all chairmen /-women of Otorhinolaryngology, Head and Neck Surgery Departments in Germany.ResultsA total of 107 respondents completed the questionnaire (65.2%). At university hospitals, 71.4% of the respondents indicated that a robotic system was available, and 21.4% responded that robotic surgery was performed at their institution; 22.7% and 0.04%, respectively, at non-university hospitals. The overall adoption rate was 0.8%. The most common cases performed were TORS resection in the oropharynx. Main reasons for not adopting this technique were costs, lack of interest and available co-operations.ConclusionThis study provides evidence of the extent of adoption of TORS in Germany; main perceived barriers to adoption are costs with lack of cost-covering reimbursement and insufficient co-operations with other disciplines as well as hospital administration resulting in a very low adoption rate of this technique over the past decade. Results from this study may assist in decision-making processes on adopting this technique in the future.
Highlights
Following approval of transoral robotic surgery (TORS) for resection of tumors in the oropharynx by the FDA in 2009, this technique had been adopted globally [1, 2]
This work presents data characterizing the adoption of robotic surgery as well as the acceptance of this technique within Otorhinolaryngology Departments in Germany as first of its kind
Estalishing a robotic program is more commonly observed in academic centers with an adoption rate of 21.4% compared to 0.04% at non-university hospitals
Summary
Following approval of transoral robotic surgery (TORS) for resection of tumors in the oropharynx by the FDA in 2009, this technique had been adopted globally [1, 2]. Indications for its use have ever since extended to various subsites of the head and neck [3, 4] beyond TORS, allowing, e.g. remote access surgery for performing neck dissections and thyroidectomies [5, 6]. The daVinci® surgical robot (Intuitive Surgical® Inc, Sunnyvale, CA, USA), allowing for a magnified and three-dimensional view through a dual endoscope, tremor filter, scaling of robotic arm movements and range of movement, is hereby the most commonly used robotic system (RS). Various perceptive barriers appear to be the reason hereby, including differences in health care systems, surgeons’ preferences, costs and access
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