title: The First Pilot Comprehensive Evaluation of the Outcomes of Different Types of Robotic Surgeries in the Different Surgical Departments: The Penta, Tetra and Trifecta Achievements in Robotic Surgeries.
abstract: BACKGROUND
  To ensure safe performance in robotic surgery, the Minimal Invasive Surgery Center (MISC) is composed of the anesthesiology department, five surgery departments and co-medical staff in our institution. The objective of this study was to evaluate the outcomes of different types of robotic surgeries for cancer treatment (n = 326) from different surgery departments in the MISC.
  
  
  METHODS
  The outcomes of robot-assisted radical prostatectomy (RARP), partial nephrectomy (RAPN), transoral robotic surgery (TORS) for pharyngeal cancer, and robotic surgery for lung, gastric and rectal cancer were evaluated using the similar concept of pentafecta in RARP.
  
  
  RESULTS
  The pentafecta rates of RARP and robotic surgery for rectal cancer were 33.3 and 56.5%, respectively. The tetrafecta rates of RARP (excluding potency evaluation from pentafecta) and TORS were 48.4 and 57.1%, respectively. The trifecta rates of RAPN, robotic surgeries for lung and gastric cancer were 75.9, 74.2 and 84.2%, respectively. The failure of tetrafecta in RARP achievement was significantly associated with high risk than with low risk according to National Comprehensive Cancer Network classification.
  
  
  CONCLUSIONS
  This is the world's first comprehensive evaluation of different types of robotic surgeries for cancer treatment in the constitutional framework of an academic institution. MISC, which provides the constitutional framework of an academic institution, is providing immeasurable benefits in terms of robotic surgery quality, and it may ultimately lead to high penta-, tetra-, and trifecta rates for robotic surgeries for cancer treatment in all surgical departments.
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
authors: Takehiro
authors: T
authors: Sejima
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
authors: Shuichi
authors: S
authors: Morizane
authors: †Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
authors: Kazunori
authors: K
authors: Fujiwara
authors: ‡Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
authors: Keigo
authors: K
authors: Ashida
authors: ‡Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
authors: Hiroaki
authors: H
authors: Saito
authors: §Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
authors: Yuji
authors: Y
authors: Taniguchi
authors: §Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
authors: Hiroshige
authors: H
authors: Nakamura
authors: Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
authors: Atsushi
authors: A
authors: Takenaka
keywords: evaluation; outcome; robotic surgery