TY - JOUR
T1 - Adoption of robotic technology for treating colorectal cancer
AU - Schootman, Mario
AU - Hendren, Samantha
AU - Ratnapradipa, Kendra
AU - Stringer, Lisa
AU - Davidson, Nick O.
N1 - Funding Information:
This work was supported by grants from the National Cancer Institute (No. CA137750) and the National Institute on Aging (No. AG049503) at the National Institutes of Health. The Health Behavior, Communication, and Outreach Core is supported in part by a National Cancer Institute Cancer Center Support Grant (No. P30 CA091842) to the Alvin J. Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis. Dr Davidson was supported in part by grants HL38180, DK56260, and Digestive Disease Research Core Center grant DK52574. The Center for Administrative Data Research is supported in part by the Washington University Institute of Clinical and Translational Sciences grant UL 1TR000448 from the National Center for Advancing Translational Sciences of the National Institutes of Health, grant No. R24 HS 19455 through the Agency for Healthcare Research and Quality, and grant No. KM1 CA156708 through the National Cancer Institute at the National Institutes of Health.
Publisher Copyright:
© The ASCRS 2016.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - BACKGROUND: Debate exists regarding the role of robotic-assisted surgery in colorectal cancer. Robotic-assisted surgery has been promoted as a strategy to increase the availability of minimally invasive surgery, which is associated with improved short-term morbidity; however, robotic-assisted surgery is much more expensive than laparoscopic surgery. OBJECTIVE: We aimed to understand hospital and patient trends in the adoption of robotic-assisted surgery. DESIGN: The study used cross-sectional and longitudinal designs. SETTINGS: The study included 2010 and 2012 American Hospital Association surveys, as well as the 2010-2012 Nationwide Inpatient Sample. PATIENTS: US hospitals responding to the American Hospital Association survey were included to measure patients with colorectal cancer who were undergoing elective minimally invasive surgery or open resection. MAIN OUTCOME MEASURES: Robotic-assisted surgery adoption by US hospitals was measured, regarding specifically patients with colorectal cancer who were treated with robotic surgery. RESULTS: In 2010, 20.1% of hospitals adopted robotic-assisted surgery, increasing to 27.4% by 2012. Hospitals more likely to adopt robotic-assisted surgery included teaching hospitals, those with more advanced imaging services, those in metropolitan rather than rural areas, and those performing the highest inpatient surgery volume. Robotic-assisted surgery only accounted for 1.3% of colorectal cancer operations during 2010-2012, but patient probability of robotic-assisted surgery ranged from 0.1% to 15.2%. The percentage of patients with colorectal cancer who were treated robotically among those undergoing minimally invasive surgery increased over time (2010, 1.5%; 2012, 3.6%). Robotic-assisted surgery is increasing more rapidly for patients with rectal cancer with minimally invasive surgery (2010, 5.5%; 2012, 13.3%) versus patients with colon cancer treated with minimally invasive surgery (2010, 1.3%; 2012, 3.3%). LIMITATIONS: The study was limited by its observational study design. CONCLUSIONS: Robotic-assisted surgery uptake remains low for colon cancer but higher for rectal cancer surgery, suggesting a more thoughtful adoption of robotic-assisted surgery for colorectal cancer by focusing its use on more technically challenging cases.
AB - BACKGROUND: Debate exists regarding the role of robotic-assisted surgery in colorectal cancer. Robotic-assisted surgery has been promoted as a strategy to increase the availability of minimally invasive surgery, which is associated with improved short-term morbidity; however, robotic-assisted surgery is much more expensive than laparoscopic surgery. OBJECTIVE: We aimed to understand hospital and patient trends in the adoption of robotic-assisted surgery. DESIGN: The study used cross-sectional and longitudinal designs. SETTINGS: The study included 2010 and 2012 American Hospital Association surveys, as well as the 2010-2012 Nationwide Inpatient Sample. PATIENTS: US hospitals responding to the American Hospital Association survey were included to measure patients with colorectal cancer who were undergoing elective minimally invasive surgery or open resection. MAIN OUTCOME MEASURES: Robotic-assisted surgery adoption by US hospitals was measured, regarding specifically patients with colorectal cancer who were treated with robotic surgery. RESULTS: In 2010, 20.1% of hospitals adopted robotic-assisted surgery, increasing to 27.4% by 2012. Hospitals more likely to adopt robotic-assisted surgery included teaching hospitals, those with more advanced imaging services, those in metropolitan rather than rural areas, and those performing the highest inpatient surgery volume. Robotic-assisted surgery only accounted for 1.3% of colorectal cancer operations during 2010-2012, but patient probability of robotic-assisted surgery ranged from 0.1% to 15.2%. The percentage of patients with colorectal cancer who were treated robotically among those undergoing minimally invasive surgery increased over time (2010, 1.5%; 2012, 3.6%). Robotic-assisted surgery is increasing more rapidly for patients with rectal cancer with minimally invasive surgery (2010, 5.5%; 2012, 13.3%) versus patients with colon cancer treated with minimally invasive surgery (2010, 1.3%; 2012, 3.3%). LIMITATIONS: The study was limited by its observational study design. CONCLUSIONS: Robotic-assisted surgery uptake remains low for colon cancer but higher for rectal cancer surgery, suggesting a more thoughtful adoption of robotic-assisted surgery for colorectal cancer by focusing its use on more technically challenging cases.
KW - American Hospital Association
KW - Colonic neoplasms
KW - Diffusion of innovation
KW - Laparoscopy
KW - Minimally invasive surgical procedures
KW - Rectal neoplasms
KW - Robotic surgical procedures
KW - Trends
UR - http://www.scopus.com/inward/record.url?scp=84992061687&partnerID=8YFLogxK
U2 - 10.1097/DCR.0000000000000688
DO - 10.1097/DCR.0000000000000688
M3 - Article
C2 - 27749475
AN - SCOPUS:84992061687
SN - 0012-3706
VL - 59
SP - 1011
EP - 1018
JO - Diseases of the Colon & Rectum
JF - Diseases of the Colon & Rectum
IS - 11
ER -