Abstract
Procedures were categorized based on surgical technique and date of the relevant hospital’s acquisition of a surgical robot. Of the over cohort, surgical technique was: 38,904 (73%) open, 6875 (13%) laparoscopic, and 7627 (14%) robotic-assisted surgery. The change in percentage of surgical type (RN vs. PN) and procedure type (Open vs. Lap) was performed based on whether it occurred before or after the hospital acquired a surgical robot. RESULTS: Before a hospital acquired a surgical robot, on average 81.6% of all renal surgery performed were RN, and this decreased to 70.1% after robot purchase; PN utilization increased from 19.2% to 31.2% after introduction of the robotic system. Over the same time period, open renal surgery decreased from 85% to 58.9% and laparoscopic decreased from 15.0% to 13.5% (see table); with a subsequent increase in robotic surgery, all values significant p1⁄4<0.001. Additionally, we found that acquisition of a surgical robot increased the utilization of robotic prostatectomies and robotic gynecologic procedures. CONCLUSIONS: This is the first report suggesting an association between hospital acquisition of a surgical robot and increased utilization of PN over RN. This is encouraging as it suggests acquisition of a surgical robot is a significant factor in advancing the utilization of PN in the treatment of renal cell carcinoma.
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