Robotic surgery trends in general surgical oncology from the National Inpatient Sample
Background Robotic surgery is offered at most major medical institutions. The extent of its use within general surgical oncology, however, is poorly understood. We hypothesized that robotic surgery adoption in surgical oncology is increasing annually, that is occurring in all surgical sites, and all...
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| Veröffentlicht in: | Surgical endoscopy 2019-08, Vol.33 (8), p.2591-2601 |
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| creator | Stewart, Camille L. Ituarte, Philip H. G. Melstrom, Kurt A. Warner, Susanne G. Melstrom, Laleh G. Lai, Lily L. Fong, Yuman Woo, Yanghee |
| description | Background
Robotic surgery is offered at most major medical institutions. The extent of its use within general surgical oncology, however, is poorly understood. We hypothesized that robotic surgery adoption in surgical oncology is increasing annually, that is occurring in all surgical sites, and all regions of the US.
Study design
We identified patients with site-specific malignancies treated with surgical resection from the National Inpatient Sample 2010–2014 databases. Operations were considered robotic if any ICD-9-CM robotic procedure code was used.
Results
We identified 147,259 patients representing the following sites: esophageal (3%), stomach (5%), small bowel (5%), pancreas (7%), liver (5%), and colorectal (75%). Most operations were open (71%), followed by laparoscopic (26%), and robotic (3%). In 2010, only 1.1% of operations were robotic; over the 5-year study period, there was a 5.0-fold increase in robotic surgery, compared to 1.1-fold increase in laparoscopy and 1.2-fold decrease in open surgery ( |
| doi_str_mv | 10.1007/s00464-018-6554-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2125295086</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2124646359</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-32fcb9608b8a248f9a982a71b212ddd9fd986d327adff84213709dd908ef82713</originalsourceid><addsrcrecordid>eNp1kEtLxDAYRYMozjj6A9xIwI2bah5Nmyxl8AWDgq9tSNtk7NAmNWkX8-_NTEcFwVU-cs93Ew4ApxhdYoTyq4BQmqUJwjzJGEsTsQemOKUkIQTzfTBFgqKE5CKdgKMQVijiArNDMKGIspwRNgXvz65wfV3CMPil9mvYe22rAGsLl9pqr5ptUpdxcLZ0jVuuofGuhf2Hho-qr52N0YPt4qhtD19U2zX6GBwY1QR9sjtn4O325nV-nyye7h7m14ukpDnpE0pMWYgM8YIrknIjlOBE5bggmFRVJUwleFZRkqvKGJ4STHMk4j3i2nCSYzoDF2Nv593noEMv2zqUummU1W4IMvYwIhjiWUTP_6ArN_j4-S0VPWaUiUjhkSq9C8FrIztft8qvJUZyI12O0mWULjfS5WbnbNc8FK2ufja-LUeAjECIkY2af5_-v_UL6TCMGQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2124646359</pqid></control><display><type>article</type><title>Robotic surgery trends in general surgical oncology from the National Inpatient Sample</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Stewart, Camille L. ; Ituarte, Philip H. G. ; Melstrom, Kurt A. ; Warner, Susanne G. ; Melstrom, Laleh G. ; Lai, Lily L. ; Fong, Yuman ; Woo, Yanghee</creator><creatorcontrib>Stewart, Camille L. ; Ituarte, Philip H. G. ; Melstrom, Kurt A. ; Warner, Susanne G. ; Melstrom, Laleh G. ; Lai, Lily L. ; Fong, Yuman ; Woo, Yanghee</creatorcontrib><description>Background
Robotic surgery is offered at most major medical institutions. The extent of its use within general surgical oncology, however, is poorly understood. We hypothesized that robotic surgery adoption in surgical oncology is increasing annually, that is occurring in all surgical sites, and all regions of the US.
Study design
We identified patients with site-specific malignancies treated with surgical resection from the National Inpatient Sample 2010–2014 databases. Operations were considered robotic if any ICD-9-CM robotic procedure code was used.
Results
We identified 147,259 patients representing the following sites: esophageal (3%), stomach (5%), small bowel (5%), pancreas (7%), liver (5%), and colorectal (75%). Most operations were open (71%), followed by laparoscopic (26%), and robotic (3%). In 2010, only 1.1% of operations were robotic; over the 5-year study period, there was a 5.0-fold increase in robotic surgery, compared to 1.1-fold increase in laparoscopy and 1.2-fold decrease in open surgery (< 0.001). These trends were observed for all surgical sites and in all regions of the US, they were strongest for esophageal and colorectal operations, and in the Northeast. Adjusting for age and comorbidities, odds of having a robotic operation increased annually (5.6 times more likely by 2014), with similar length of stay (6.9 ± 6.5 vs 7.0 ± 6.5,
p
= 0.52) and rate of complications (OR 0.91, 95% CI 0.83–1.01,
p
= 0.08) compared to laparoscopy.
Conclusions
Robotic surgery as a platform for minimally invasive surgery is increasing over time for oncologic operations. The growing use of robotic surgery will affect surgical oncology practice in the future, warranting further study of its impact on cost, outcomes, and surgical training.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-018-6554-9</identifier><identifier>PMID: 30357525</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Aged ; Cancer surgery ; Databases, Factual ; Digestive System Surgical Procedures - methods ; Digestive System Surgical Procedures - trends ; Esophagus ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Humans ; Laparoscopy ; Laparoscopy - trends ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Minimally invasive surgery ; Minimally Invasive Surgical Procedures - trends ; Oncology ; Postoperative Complications - epidemiology ; Proctology ; Retrospective Studies ; Robotic surgery ; Robotic Surgical Procedures - trends ; Surgery ; Surgical Oncology - methods ; Surgical Oncology - trends ; Trends</subject><ispartof>Surgical endoscopy, 2019-08, Vol.33 (8), p.2591-2601</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Surgical Endoscopy is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-32fcb9608b8a248f9a982a71b212ddd9fd986d327adff84213709dd908ef82713</citedby><cites>FETCH-LOGICAL-c372t-32fcb9608b8a248f9a982a71b212ddd9fd986d327adff84213709dd908ef82713</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-018-6554-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-018-6554-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30357525$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stewart, Camille L.</creatorcontrib><creatorcontrib>Ituarte, Philip H. G.</creatorcontrib><creatorcontrib>Melstrom, Kurt A.</creatorcontrib><creatorcontrib>Warner, Susanne G.</creatorcontrib><creatorcontrib>Melstrom, Laleh G.</creatorcontrib><creatorcontrib>Lai, Lily L.</creatorcontrib><creatorcontrib>Fong, Yuman</creatorcontrib><creatorcontrib>Woo, Yanghee</creatorcontrib><title>Robotic surgery trends in general surgical oncology from the National Inpatient Sample</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Robotic surgery is offered at most major medical institutions. The extent of its use within general surgical oncology, however, is poorly understood. We hypothesized that robotic surgery adoption in surgical oncology is increasing annually, that is occurring in all surgical sites, and all regions of the US.
Study design
We identified patients with site-specific malignancies treated with surgical resection from the National Inpatient Sample 2010–2014 databases. Operations were considered robotic if any ICD-9-CM robotic procedure code was used.
Results
We identified 147,259 patients representing the following sites: esophageal (3%), stomach (5%), small bowel (5%), pancreas (7%), liver (5%), and colorectal (75%). Most operations were open (71%), followed by laparoscopic (26%), and robotic (3%). In 2010, only 1.1% of operations were robotic; over the 5-year study period, there was a 5.0-fold increase in robotic surgery, compared to 1.1-fold increase in laparoscopy and 1.2-fold decrease in open surgery (< 0.001). These trends were observed for all surgical sites and in all regions of the US, they were strongest for esophageal and colorectal operations, and in the Northeast. Adjusting for age and comorbidities, odds of having a robotic operation increased annually (5.6 times more likely by 2014), with similar length of stay (6.9 ± 6.5 vs 7.0 ± 6.5,
p
= 0.52) and rate of complications (OR 0.91, 95% CI 0.83–1.01,
p
= 0.08) compared to laparoscopy.
Conclusions
Robotic surgery as a platform for minimally invasive surgery is increasing over time for oncologic operations. The growing use of robotic surgery will affect surgical oncology practice in the future, warranting further study of its impact on cost, outcomes, and surgical training.</description><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Cancer surgery</subject><subject>Databases, Factual</subject><subject>Digestive System Surgical Procedures - methods</subject><subject>Digestive System Surgical Procedures - trends</subject><subject>Esophagus</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - trends</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Minimally invasive surgery</subject><subject>Minimally Invasive Surgical Procedures - trends</subject><subject>Oncology</subject><subject>Postoperative Complications - epidemiology</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - trends</subject><subject>Surgery</subject><subject>Surgical Oncology - methods</subject><subject>Surgical Oncology - trends</subject><subject>Trends</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kEtLxDAYRYMozjj6A9xIwI2bah5Nmyxl8AWDgq9tSNtk7NAmNWkX8-_NTEcFwVU-cs93Ew4ApxhdYoTyq4BQmqUJwjzJGEsTsQemOKUkIQTzfTBFgqKE5CKdgKMQVijiArNDMKGIspwRNgXvz65wfV3CMPil9mvYe22rAGsLl9pqr5ptUpdxcLZ0jVuuofGuhf2Hho-qr52N0YPt4qhtD19U2zX6GBwY1QR9sjtn4O325nV-nyye7h7m14ukpDnpE0pMWYgM8YIrknIjlOBE5bggmFRVJUwleFZRkqvKGJ4STHMk4j3i2nCSYzoDF2Nv593noEMv2zqUummU1W4IMvYwIhjiWUTP_6ArN_j4-S0VPWaUiUjhkSq9C8FrIztft8qvJUZyI12O0mWULjfS5WbnbNc8FK2ufja-LUeAjECIkY2af5_-v_UL6TCMGQ</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Stewart, Camille L.</creator><creator>Ituarte, Philip H. G.</creator><creator>Melstrom, Kurt A.</creator><creator>Warner, Susanne G.</creator><creator>Melstrom, Laleh G.</creator><creator>Lai, Lily L.</creator><creator>Fong, Yuman</creator><creator>Woo, Yanghee</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20190801</creationdate><title>Robotic surgery trends in general surgical oncology from the National Inpatient Sample</title><author>Stewart, Camille L. ; Ituarte, Philip H. G. ; Melstrom, Kurt A. ; Warner, Susanne G. ; Melstrom, Laleh G. ; Lai, Lily L. ; Fong, Yuman ; Woo, Yanghee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-32fcb9608b8a248f9a982a71b212ddd9fd986d327adff84213709dd908ef82713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdominal Surgery</topic><topic>Aged</topic><topic>Cancer surgery</topic><topic>Databases, Factual</topic><topic>Digestive System Surgical Procedures - methods</topic><topic>Digestive System Surgical Procedures - trends</topic><topic>Esophagus</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - trends</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Minimally invasive surgery</topic><topic>Minimally Invasive Surgical Procedures - trends</topic><topic>Oncology</topic><topic>Postoperative Complications - epidemiology</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Robotic surgery</topic><topic>Robotic Surgical Procedures - trends</topic><topic>Surgery</topic><topic>Surgical Oncology - methods</topic><topic>Surgical Oncology - trends</topic><topic>Trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stewart, Camille L.</creatorcontrib><creatorcontrib>Ituarte, Philip H. G.</creatorcontrib><creatorcontrib>Melstrom, Kurt A.</creatorcontrib><creatorcontrib>Warner, Susanne G.</creatorcontrib><creatorcontrib>Melstrom, Laleh G.</creatorcontrib><creatorcontrib>Lai, Lily L.</creatorcontrib><creatorcontrib>Fong, Yuman</creatorcontrib><creatorcontrib>Woo, Yanghee</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stewart, Camille L.</au><au>Ituarte, Philip H. G.</au><au>Melstrom, Kurt A.</au><au>Warner, Susanne G.</au><au>Melstrom, Laleh G.</au><au>Lai, Lily L.</au><au>Fong, Yuman</au><au>Woo, Yanghee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic surgery trends in general surgical oncology from the National Inpatient Sample</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>33</volume><issue>8</issue><spage>2591</spage><epage>2601</epage><pages>2591-2601</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Robotic surgery is offered at most major medical institutions. The extent of its use within general surgical oncology, however, is poorly understood. We hypothesized that robotic surgery adoption in surgical oncology is increasing annually, that is occurring in all surgical sites, and all regions of the US.
Study design
We identified patients with site-specific malignancies treated with surgical resection from the National Inpatient Sample 2010–2014 databases. Operations were considered robotic if any ICD-9-CM robotic procedure code was used.
Results
We identified 147,259 patients representing the following sites: esophageal (3%), stomach (5%), small bowel (5%), pancreas (7%), liver (5%), and colorectal (75%). Most operations were open (71%), followed by laparoscopic (26%), and robotic (3%). In 2010, only 1.1% of operations were robotic; over the 5-year study period, there was a 5.0-fold increase in robotic surgery, compared to 1.1-fold increase in laparoscopy and 1.2-fold decrease in open surgery (< 0.001). These trends were observed for all surgical sites and in all regions of the US, they were strongest for esophageal and colorectal operations, and in the Northeast. Adjusting for age and comorbidities, odds of having a robotic operation increased annually (5.6 times more likely by 2014), with similar length of stay (6.9 ± 6.5 vs 7.0 ± 6.5,
p
= 0.52) and rate of complications (OR 0.91, 95% CI 0.83–1.01,
p
= 0.08) compared to laparoscopy.
Conclusions
Robotic surgery as a platform for minimally invasive surgery is increasing over time for oncologic operations. The growing use of robotic surgery will affect surgical oncology practice in the future, warranting further study of its impact on cost, outcomes, and surgical training.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30357525</pmid><doi>10.1007/s00464-018-6554-9</doi><tpages>11</tpages></addata></record> |
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| subjects | Abdominal Surgery Aged Cancer surgery Databases, Factual Digestive System Surgical Procedures - methods Digestive System Surgical Procedures - trends Esophagus Female Gastroenterology Gynecology Hepatology Humans Laparoscopy Laparoscopy - trends Male Medicine Medicine & Public Health Middle Aged Minimally invasive surgery Minimally Invasive Surgical Procedures - trends Oncology Postoperative Complications - epidemiology Proctology Retrospective Studies Robotic surgery Robotic Surgical Procedures - trends Surgery Surgical Oncology - methods Surgical Oncology - trends Trends |
| title | Robotic surgery trends in general surgical oncology from the National Inpatient Sample |
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