title: Incidence of surgical site infection associated with robotic surgery.
abstract: OBJECTIVE
  Robot-assisted surgery is minimally invasive and associated with less blood loss and shorter recovery time than open surgery. We aimed to determine the duration of robot-assisted surgical procedures and the incidence of postoperative surgical site infection (SSI) and to compare our data with the SSI incidence for open procedures according to national data.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A 689-bed academic medical center.
  
  
  METHODS
  All patients who underwent a surgical procedure with use of a robotic surgical system during the period from 2000-2007.
  
  
  METHODS
  SSIs were defined and procedure types were classified according to National Healthcare Safety Network criteria. National data for comparison were from 1992-2004. Because of small sample size, procedures were grouped according to surgical site or wound classification.
  
  
  RESULTS
  Sixteen SSIs developed after 273 robot-assisted procedures (5.9%). The mean surgical duration was 333.6 minutes. Patients who developed SSI had longer mean surgical duration than did patients who did not (558 vs 318 minutes; P<.001). The prostate and genitourinary group had 5.74 SSIs per 100 robot-assisted procedures (95% confidence interval [CI], 2.81-11.37), compared with 0.85 SSIs per 100 open procedures from national data. The gynecologic group had 10.00 SSIs per 100 procedures (95% CI, 2.79-30.10), compared with 1.72 SSIs per 100 open procedures. The colon and herniorrhaphy groups had 33.33 SSIs per 100 procedures (95% CI, 9.68-70.00) and 37.50 SSIs per 100 procedures (95% CI, 13.68-69.43), respectively, compared with 5.88 and 1.62 SSIs per 100 open procedures from national data. Patients with a clean-contaminated wound developed 6.1 SSIs per 100 procedures (95% CI, 3.5-10.3), compared with 2.59 SSIs per 100 open procedures. No significant differences in SSI rates were found for other groups.
  
  
  CONCLUSIONS
  Increased incidence of SSI after some types of robot-assisted surgery compared with traditional open surgery may be related to the learning curve associated with use of the robot.
authors.affiliation: Pharmacy Relations and Clinical Decision Support, the Department of Pharmaceutical and Nutrition Care, Nebraska Medical Center, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska 68198-4031, USA. ehermsen@nebraskamed.com
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Hermsen
authors.forename: Tim
authors.initials: T
authors.lastname: Hinze
authors.forename: Harlan
authors.initials: H
authors.lastname: Sayles
authors.forename: Lee
authors.initials: L
authors.lastname: Sholtz
authors.forename: Mark E
authors.initials: ME
authors.lastname: Rupp
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009329:Nebraska / Q000453:epidemiology; D012189:Retrospective Studies; D012371:Robotics; D013514:Surgical Procedures, Operative / Q000009:adverse effects* / Q000379:methods; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors