Current Trend of Robotic Thoracic and Cardiovascular Surgeries in Korea: Analysis of Seven-Year National Data.
BACKGROUND
Robotic surgery is an alternative to minimally invasive surgery. The aim of this study was to report on current trends in robotic thoracic and cardiovascular surgical techniques in Korea.


METHODS
Data from the National Evidence-based Healthcare Collaborating Agency (NECA) between January 2006 and June 2012 were used in this study, including a total of 932 cases of robotic surgeries reported to NECA. The annual trends in the case volume, indications for robotic surgery, and distribution by hospitals and surgeons were analyzed in this study.


RESULTS
Of the 932 cases, 591 (63%) were thoracic operations and 340 (37%) were cardiac operations. The case number increased explosively in 2007 and 2008. However, the rate of increase regained a steady state after 2011. The main indications for robotic thoracic surgery were pulmonary disease (n=271, 46%), esophageal disease (n=199, 34%), and mediastinal disease (n=117, 20%). The main indications for robotic cardiac surgery were valvular heart disease (n=228, 67%), atrial septal defect (n=79, 23%), and cardiac myxoma (n=27, 8%). Robotic thoracic and cardiovascular surgeries were performed in 19 hospitals. Three large volume hospitals performed 94% of the case volume of robotic cardiac surgery and 74% of robotic thoracic surgery. Centralization of robotic operation was significantly (p<0.0001) more common in cardiac surgery than in thoracic surgery. A total of 39 surgeons performed robotic surgeries. However, only 27% of cardiac surgeons and 23% of thoracic surgeons performed more than 10 cases of robotic surgery.


CONCLUSIONS
Trend analysis of robotic and cardiovascular operations demonstrated a gradual increase in the surgical volume in Korea. Meanwhile, centralization of surgical cases toward specific surgeons in specific hospitals was observed.
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital.
Chang Hyun
CH
Kang
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital.
Jin San
JS
Bok
Department of Health Technology Assessment, National Evidence-based Healthcare Collaborating Agency.
Na Rae
NR
Lee
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital.
Young Tae
YT
Kim
Department of Nursing Science, Gachon University College of Nursing.
Seon Heui
SH
Lee
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital.
Cheong
C
Lim
Cardiac surgery; Robotics; Thoracic surgery