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Robotic surgery in public hospitals of Latin-America: a castle of sand?

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Abstract

Introduction

There is no information about the evolution of robotic programs in public hospitals of Latin-America.

Objective

To describe the current status and functioning of robotic programs in Latin-American public hospitals since their beginning to date.

Methods

We conducted a survey among leading urologists working at public hospitals of Latin-America who had acquired the Da Vinci laparoscopic-assisted robotic system. Questions included: date the program started, its utilization by other services, number and kind of surgeries, surgery paying system, surgery related deaths, occurrence and reasons of robotic program interruptions and its use for training purposes. Medians and 25–75 centiles (IQR) were estimated.

Results

Since 2009, there are ten public hospitals of four Latin-American countries that acquired the Da Vinci robotic system. The median number of months robotic programs has been functioning without considering transitory interruption: 43 (IQR 35, 55). Median number of urologic and total surgeries performed: 140 (IQR 94, 168) and 336 (IQR 292, 621), respectively. The corresponding median number of urologic and total surgeries performed per month: 3 (IQR 2, 5) and 8 (IQR 5, 11). Median number of total surgeries performed per year per institution was 94 (IQR 68,123). The median proportion of urologic cases was 40% (IQR 31, 48), ranging from 24 to 66%. Five of ten institutions had their urology programs transitory or definitively closed due to the high burden costs.

Conclusion

Adoption and development of robotic surgery in some public hospitals of Latin-America have been hindered by high costs.

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Author information

Authors and Affiliations

  1. Hospital Universitario CEMIC, Buenos Aires, Argentina

    Fernando P. Secin

  2. Universidade de São Paulo, São Paulo, Brazil

    Rafael Coelho

  3. Hospital de Trauma Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina

    Juan I. Monzó Gardiner & Diana Finkelstein

  4. Hospital central militar, Mexico City, México

    Jose Gadú Campos Salcedo

  5. Hospital Británico de Montevideo, Montevideo, Uruguay

    Roberto Puente

  6. Hospital de Clínicas, Facultad de Medicina - Universidad de la República, Montevideo, Uruguay

    Levin Martínez

  7. Hospital Universitario de Caracas, Caracas, Venezuela

    Rair Valero, Antonio León & Hugo Dávila Barrios

  8. Hospital Escuela de Agudos Dr. Ramón Madariaga, Misiones, Argentina

    Daniel Angeloni

  9. Hospital Británico de Buenos Aires, Buenos Aires, Argentina

    José Rozanec

  10. Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

    Milton Berger

  11. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

    Leandro Totti Cavazzola

  12. Hospital de cáncer de Barretos, San Pablo, Brazil

    Eliney Ferreira Faria & Roberto Días Machado

  13. Brazilian National Cancer Institute, INCA, Rio do Janeiro, Brazil

    Felipe Lott & Franz Campos

  14. Hospital General Dr. Manuel Gea González, Mexico City, México

    Jorge G. Morales Montor

  15. Hospital Regional de Alta Especialidad de Zumpango, Zumpango de Ocampo, México

    Carlos Sánchez Moreno

Authors
  1. Fernando P. Secin
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  2. Rafael Coelho
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  3. Juan I. Monzó Gardiner
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  4. Jose Gadú Campos Salcedo
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  5. Roberto Puente
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  6. Levin Martínez
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  7. Diana Finkelstein
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  8. Rair Valero
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  9. Antonio León
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  10. Daniel Angeloni
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  11. José Rozanec
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  12. Milton Berger
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  13. Leandro Totti Cavazzola
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  14. Eliney Ferreira Faria
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  15. Roberto Días Machado
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  16. Felipe Lott
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  17. Franz Campos
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  18. Jorge G. Morales Montor
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  19. Carlos Sánchez Moreno
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  20. Hugo Dávila Barrios
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Contributions

FP Secin, protocol/project development, data collection and management, data analysis, and manuscript writing/editing. RC, data collection and management, data analysis, and manuscript editing. JIMG, data collection and management, data analysis, and manuscript editing. JGCS, data collection and management, data analysis, and manuscript editing. RP, data collection and management, and manuscript editing. LM, data collection and management, data analysis, and manuscript editing. DF, data collection and management, data analysis, and manuscript editing. RV, data collection and management, data analysis, and manuscript editing. AL, data collection and management, and manuscript editing. DA, data collection and management, data analysis, and manuscript editing. JR, data collection and management, data analysis, and manuscript editing. MB, data collection and management, data analysis, and manuscript editing. LTC, data collection and management, data analysis, and manuscript editing. EFF, data collection and management, data analysis, and manuscript editing. RDM, data collection and management, data analysis, and manuscript editing. FL, data collection and management, data analysis, and manuscript editing. FC, data collection and management, data analysis, and manuscript editing. JGMM, data collection and management, data analysis, and manuscript editing. CSM, data collection and management, data analysis, and manuscript editing. HDB, project development, data collection, and manuscript editing.

Corresponding author

Correspondence to Fernando P. Secin.

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None reported.

Research involving Human participants or animals

None.

Informed consent

This is retrospective study where no patient information was required, therefore, patient consent was not needed.

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Secin, F.P., Coelho, R., Monzó Gardiner, J.I. et al. Robotic surgery in public hospitals of Latin-America: a castle of sand?. World J Urol 36, 595–601 (2018). https://doi.org/10.1007/s00345-018-2227-5

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  • DOI: https://doi.org/10.1007/s00345-018-2227-5

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