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    Robot may negatively impact surgical crisis outcomes

    Increased risk for major complication most pronounced in healthiest patients

    Boston—A crisis situation during minimally invasive urologic surgery is equally rare during either a robotic or a laparoscopic procedure. However, use of the robot may negatively impact the outcome of the event and particularly among healthier patients, according to the findings of a recent study.

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    “The main message from our research may be that the overall rate of catastrophic complications during minimally invasive urologic surgery is very low. Most pending crises can be controlled, and my personal sense is that they can be better controlled during a robotic procedure than laparoscopically,” said first author Courtney K. Rowe, MD, a urology resident at Brigham and Women’s Hospital, Boston, who presented the findings at the 2015 AUA annual meeting in New Orleans on behalf of a multi-institutional group.

    “However, our study should start the conversation about ways to improve the design of robotic technology to allow quicker access if something bad happens as well as advances in emergency simulation so that surgeons can be prepared for these rare events if they occur,” added Dr. Rowe, who worked on the study with Steven L. Chang, MD, MS, and co-authors.

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    Aiming to investigate whether the set-up of a robotic procedure with the surgeon displaced from the bedside and the complexity of the equipment might affect the risk and outcomes of a crisis, the authors performed a comparative population-based analysis using a nationally representative discharge hospital database. They evaluated a survey-rated sample of nearly 600,000 patients who underwent a robotic or laparoscopic procedure between 2003 and 2013.

    Next: Case mix differed between surgical groups

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