DeRAS I – deutsche Situation der robotisch assistierten Chirurgie – eine Online-Survey-Studie

摘要

BACKGROUND: Robotic assistance has become established in surgery but is not yet a standard procedure. The current status of clinical dissemination in Germany remains unclear. Industry independent sources are scarce. AIM OF THE WORK: The aim of this survey was to investigate the current status of robotic-assisted surgery (RAS) across specialties in Germany from 2014 to 2018. MATERIAL AND METHODS: An internet search was used to identify hospitals and departments (DP) with access to RAS. The DPs were asked to share their data from 2014-2018. In addition to clinical data, data on utilization, implementation, training, and funding were requested. RESULTS: As of 31 December 2018 RAS was offered at 121 hospitals in Germany, 383 DPs with access to RAS were identified and 26% (n = 98) of DPs responded. On average each DP had two consultant surgeons, 10% of DPs had more than one RAS system and 100% of the RAS systems recorded were from Intuitive Surgical Inc., CA, USA. RAS was implemented in 65% in urology and in 12% in visceral surgery (VS). 21% of programs were interdisciplinary and 4% multidisciplinary (> 3). 83% of systems were purchased and 17% otherwise funded. For additional operating room costs, 74% of hospitals reported paying for them themselves. 14% chose pay as you go. Since 2014, procedures increased by a factor of 4 to approximately 8000. The proportion of VS increased by a factor of 5 since 2016. CONCLUSION: RAS in Germany experienced strong growth through 2018. The range of procedures is similar to that of laparoscopy. With a current lack of reimbursement for the additional technical effort, RAS is predominantly used in the medium and high complexity range. The online survey is a good method to collect independent data without high administrative effort.