Current status of robot-assisted surgery in urology: a multi-national survey of 297 urologic surgeons.

Abstract

PURPOSE: The surgical robot is becoming an important tool for performance of minimally invasive surgical procedures around the world. We surveyed opinions about and utilization of robot-assisted surgery among urologic surgeons from 44 countries. MATERIAL AND METHODS: A total of 297 surveys were completed from September to November 2008 by participating urologic surgeons polled at various national and international urologic meetings. The survey evaluated surgeon background, personal experience with minimally invasive surgery, institutional status regarding robotic surgery surgeons' attitudes towards robot-assisted surgery, in general, and prostate, bladder and kidney oncologic procedures, specifically. RESULTS: Two hundred ninety-seven participants completed the survey of which 35% were in training for and 54% in practice of urology. Although 57% of these participants were older than 40, 62% had never sat on a robotic surgical console but 61% believed they would perform robot-assisted surgery. Seventy-eight percent of respondents felt it was required or beneficial to have training in robot-assisted surgery. Only 21% of respondents were currently performing robot-assisted radical prostatectomy. Sixty-one percent of respondents felt robot-assisted radical prostatectomy was the current gold standard or as good as laparoscopic prostatectomy. Only 10% had performed robot-assisted radical cystectomy and 70% of these surgeons have transferred skills from robot-assisted radical prostectomy. Ten percent were performing robot-assisted radical nephrectomies and 30% had transferred skills for laparoscopic partial nephrectomy to robot-assisted partial nephrectomy. CONCLUSION: Robot-assisted surgery has begun to integrate into the minimally invasive armamentarium for urologic surgery and is applied for more procedures as experience is gained.