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The Da Vinci surgical robot clinical operating assessment

Maida, Giorgio (2013) The Da Vinci surgical robot clinical operating assessment. Doctoral Thesis.

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Abstract

This work aims at study as robotic surgery with DaVinci robot may influence clinical results and economic expenditure in two surgical Departments in S. Francesco Hospital, Nuoro.
A series of anagrafics/healthy/outcome indicators has been formulated, finding the costs correlated to them.
Patients: 66 undergone robotic/open (46/20) retropubic radical prostatectomy (PPR) and 52 undergone robotic/laparoscopic (30/22) right hemicolectomy (EMI) PPR - Since the arrival of the robot, attractiveness is raised.
Perioperative blood loss is less frequent in robotic procedures (2,2% vs 55%, p =.001) and with less blood amount (500 vs 891 cc), as it is for peri-/intra-operative complications (0% vs 10% and 19,5% vs 40%).
Robotic PPR allows a 2-days anticipated patients discharge (p =.002) and a 1-day bladder catheter removal (p<.005).
EMI - Globally, comparison shows no differences. There are a few advantages for robotic procedures in time of patient discharge (1 day), percentage of patient transfused and adverse events, although none of these shows statistical significance.
Surgical time appears a critical parameter for both procedures, although less in EMI.
Costs are calculated in PPR, including fixed (purchase/maintenance/instruments) and variable (clinical/other) ones. A difference of €33.337/procedure is found, to the detriment of robotic surgery.
Robotic surgery is an effective, attractive and evolving technology, although economic expenditure remains an obstacle to the diffusion of robots.

Item Type:Doctoral Thesis
ID Code:8290
Contributors:Azara, Antonio Alfredo
Publisher:Università degli studi di Sassari
Uncontrolled Keywords:Robot, chirurgia, Sardinia
Subjects:Area 06 - Scienze mediche > MED/42 Igiene generale e applicata
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Biomediche
Cicli, scuole e corsi:Ciclo 25 > Scuole > Scienze biomediche > Sanità pubblica ed evidence based prevention
Deposited On:03 Apr 2013 12:22

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