[Multidisciplinary development of robotic surgery in a University Tertiary Hospital: Organization and outcomes].
BACKGROUND
Da Vinci system (Intuitive Surgical) is a surgical telemanipulator providing many technical advantages over conventional laparoscopic approach (3-D vision, ergonomics, highly precise movements, endowrist instrumentation...) and it is currently applied to several specialties throughout the world since 2000. The first Spanish public hospital incorporating this robotic technology was Hospital Clinico San Carlos (HCSC) in Madrid, in July 2006. We present the multidisciplinary organization and clinical, research and training outcomes of the Robotic Surgery Plan developed in the HCSC.


METHODS
Starting from joint management and joint scrub nurses team, General and Digestive Surgery, Urology and Gynaecology Departments were progressively incorporated into the Robotic Surgery Plan, with several procedures increasing in complexity. A number of intra and extra-hospital teaching and information activities were planned to report on the Robotic Surgery Plan.


RESULTS
Between July 2006 and July 2008, 306 patients were operated on: 169 by General Surgery, 107 by Urology and 30 by Gynaecology teams. The outcomes showed feasibility and a short learning curve. The educational plan included residents and staff interested in robotic technology application.


CONCLUSIONS
The structured and gradual incorporation of robotic surgery throughout the PCR-HCSC has made it easier to learn, to share designed infrastructure, to coordinate information activities and multidisciplinary collaboration. This preliminary experience has shown the efficiency of an adequate organization and motivated team.
Ortiz Oshiro
Elena
E
Servicio de Cirugía I, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, España. ortosh@hotmail.com
Ramos Carrasco
Angel
A
Moreno Sierra
Jesús
J
Pardo Martínez
Cristina
C
Galante Romo
Isabel
I
Bullón Sopelana
Fernando
F
Coronado Martín
Pluvio
P
Mansilla García
Iván
I
Escudero Mate
María
M
Vidart Aragón
José A
JA
Silmi Moyano
Angel
A
Alvarez Fernández-Represa
Jesús
J
D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D017063:Outcome Assessment, Health Care; D012371:Robotics; D013503:Surgery Department, Hospital / Q000458:organization & administration*