Science

ROBOTIC SURGERY significantly reduces recovery time

In addition to reducing hospitalization time, robotic surgery reduces the risk of readmission by half (52%) and reduces by 77% the incidence of blood clots (deep vein thrombi and pulmonary embolism), which are an important cause of complications and morbidity with this type of intervention. “While robotic surgery is becoming more accessible, its benefits in terms of patient recovery have not yet been evaluated. Finally, previous trials have focused on long-term outcomes and have shown similar cancer cure rates and similar levels of long-term recovery after surgery. But no one has yet considered the difference in recovery time after surgery.

Finally, in most countries, open surgery remains the standard recommendation for complex surgeries.

Here, the team sought to establish this benefit of reducing time spent in the hospital, readmission rates, and improving patient fitness and quality of life.

“and this is demonstrated in all points.”

Robotic surgery or open surgery? In open surgery, the surgeon works directly with the patient in a more invasive way by making incisions in the skin and muscles. In the case of robotic surgery, the surgeon guides minimally invasive instruments remotely using a console and 3D vision. This type of machinery and equipment is still only available in a small number of hospitals.

Bladder cancer example: Bladder cancer is characterized by a tumor that develops in the lining of the bladder. In some cases, the tumor spreads to the bladder muscle and can lead to secondary cancer in other parts of the body. It is one of the most difficult and costly types of cancer.

The study is being conducted in 9 hospitals with 338 patients with non-metastatic bladder cancer, divided into 2 groups:

  • 169 patients underwent robot-assisted radical cystectomy (removal of the bladder) with intracorporeal reconstruction (the process of removing a portion of the intestine to create a new bladder);
  • 169 patients underwent open radical cystectomy.

The primary endpoint of the study was the length of hospital stay after surgery:

  • on average, the “robot-assisted surgery” group spent 8 days in the hospital compared to 10 days in the open surgery group, a reduction of 20%;
  • readmission within 90 days of surgery was also significantly reduced: 21% in the robotic surgery group compared to 32% in the open surgery group;
  • thrombus prevalence, wound complications, quality of life, disability, endurance, activity level, and survival (morbidity), all of these secondary outcomes improve with robotic surgery or, if they do not improve, are similar to the results obtained. with open surgery.

Another striking result of this clinical trial is that robotic-assisted surgery patients return to normal daily activities faster and recover faster and more intensely from physical activity, as evidenced by daily step counts tracked by the sensor. These patients also improved endurance and quality of life. Finally, an unexpected result of this study is a striking reduction in blood clots in patients undergoing robotic surgery.

Strong Evidence for Patient Benefits of Robotic Surgery: These data are prompting researchers to call on health authorities to expand access to this clinical option in more locations and for all major abdominal surgeries, including colorectal, gastrointestinal, and gynecological.

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