Surgeon Volume and Clinical Outcomes After Robotic Elective and Emergency General Surgery.
Very high volume surgeons had lower odds of conversion to open surgery in elective cases.
Surgeon Volume and Clinical Outcomes After Robotic Elective and Emergency General Surgery.
IMPORTANCE: Robotic-assisted surgery is increasingly used in acute care surgery, but the impact of individual surgeon robotic case volume on outcomes for both elective and emergency general surgery procedures remains uncertain.
To evaluate the association between annual surgeon robotic case volume and patient outcomes following robotic-assisted elective and emergency general surgery.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used data from the Premier Healthcare Database (Premier Healthcare Database), a large US all-payer hospital database, from January 2021 to December 2023.
very high volume surgeons had 55% lower odds of converting to open surgery
Among 185 924 patients undergoing robotic procedures (137 879 elective and 48 045 emergency), most (58.2%) were female (57.1% of elective and 61.5% of emergency cases).
Mean (SD) patient age was 54.9 (16.6) years overall (55.6 [15.8] years for elective and 53.0 [18.5] years for emergency procedures).
Operative time (mean ratio, 0.77; 95% CI, 0.75-0.79), hospital length of stay (mean ratio, 0.89; 95% CI, 0.88-0.91), and costs (mean ratio, 0.83; 95% CI, 0.82-0.84) were also significantly lower.
In this cohort study, greater annual surgeon robotic case volume was associated with better patient outcomes in elective general surgery and, to a lesser degree, in emergency procedures.
These findings highlight the importance of surgeon-specific experience in robotic surgery and may inform training, credentialing, and strategies for safe expansion of robotic capabilities in acute care surgery.