title: Implementation of a multidisciplinary robotic centre in a high-volume university hospital.
abstract: BACKGROUND
  We describe the initiation of a multidisciplinary centre for robotic surgery including the implementation of robotic-assisted procedures as standard procedure for the majority of cancer operations in urology, gynaecology and gastrointestinal surgery.
  
  
  METHODS
  All robotic procedures performed from 2008 to 2013 were included. The information gathered included body mass index, the American Society of Anesthesiologists' physical status classification value (ASA), age, sex, time and type of surgery, duration of procedure, conversion to open surgery, length and type of anaesthesia, re-operations, length of hospital stay and 30-day mortality.
  
  
  RESULTS
  The implementation strategy was to start with one specialty at a time, passing on experience from one specialty to the next. The surgical strategy was to begin with standard procedures for which international experience was available and subsequently perform more complex procedures, ending up with robotic-assisted procedures as the standard for most cancer surgery procedures. A total of 2,473 procedures were performed. The operative time was reduced over the period for the main procedures of all three specialties. For prostatectomies, hysterectomies and colectomies, conversion to open surgery occurred in 1.2, 3.8 and 7.7%; the risk of re-operation was 0.2, 2.3 and 7.3%; and, finally, the 30-day mortality was 0.1, 0 and 1%, respectively.
  
  
  CONCLUSIONS
  The implementation was possible as a stepwise introduction across three specialties with low conversion and re-operation rates and a low mortality. A high-volume centre for robotic surgery was developed and patients with malignant diagnoses were offered robotic-assisted surgery within the framework of multidisciplinary cooperation.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  The study was approved by the Danish Data Protection Agency R. No.: 2007-58-0015.
authors.affiliation: Agertoften 7, 2820 Gentofte, Denmark. sakw@regionsjaelland.dk.
authors.forename: Sara
authors.initials: S
authors.lastname: Kehlet Watt
authors.forename: Henrik Loft
authors.initials: HL
authors.lastname: Jakobsen
authors.forename: Rasmus
authors.initials: R
authors.lastname: Vogelsang
authors.forename: Bjarne
authors.initials: B
authors.lastname: Kromann-Andersen
authors.forename: Connie
authors.initials: C
authors.lastname: Palle
authors.forename: Ligita
authors.initials: L
authors.lastname: Paskeviciute Frøding
authors.forename: Bjørn
authors.initials: B
authors.lastname: Dreijer
authors.forename: Ismail
authors.initials: I
authors.lastname: Gögenur
mesh_terms: D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D003718:Denmark; D013505:Digestive System Surgical Procedures / Q000379:methods; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006284:Health Plan Implementation / Q000706:statistics & numerical data*; D061847:Hospitals, High-Volume; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016522:Oncology Service, Hospital / Q000458:organization & administration*; D061646:Operative Time; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000706:statistics & numerical data*; D012371:Robotics / Q000458:organization & administration*; D013520:Urologic Surgical Procedures / Q000379:methods