title: Standardized surgical technique and dedicated operating room environment can reduce the operative time during robotic-assisted surgery for pelvic floor disorders.
abstract: Robotic-assisted surgery for pelvic floor disorders (PFD) meets the accepted standards for laparoscopic surgery. The aim of this study was to describe the technique and the impact of this standardized surgical technique and dedicated operating teams on the operative time for robotic-assisted laparoscopic ventral mesh rectopexy (RALVMR). Data from a prospective database were extracted for all patients who underwent RALVMR between January 2008 and May 2012 for multi-compartment PFD. Patient pre-, intra- and early postoperative data were analysed. To evaluate the impact of both the surgical technique and operating room team on operative time over successive years, we divided the total operation time (TOT) into robot set-up time (RST) and surgeon console time (SCT) including disembarking robotic arms and closure of wounds. A total of 51 patients (3 male) with a mean age of 61.1 [±11, standard deviation (SD)] years were included for analysis. There were no major complications or deaths. Median TOT fell significantly by 23 % from 2008 (270 min) to 2012 (179 min) (p < 0.0001). The largest reduction (>60 %) was seen in RST, from 55 (SD ±3) to 21 (SD ±2) min (p < 0.0001). Similarly, SCT was reduced by 36 % from 216 (SD ±12) to 138 (SD ±8) min (p < 0.0001). Decreased operative time and efficiency were facilitated by a devoted, well-trained and consistent team. A standardized surgical technique for PFD helps to reduce the duration of the surgical procedure.
authors.affiliation: Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes, Hotel Dieu 1, Place Alexis Ricordeau, 44093, Nantes, France. skmantoo@gmail.com.
authors.forename: Surendra
authors.initials: S
authors.lastname: Mantoo
authors.affiliation: Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes, Hotel Dieu 1, Place Alexis Ricordeau, 44093, Nantes, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Rigaud
authors.affiliation: Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes, Hotel Dieu 1, Place Alexis Ricordeau, 44093, Nantes, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Naulet
authors.affiliation: Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes, Hotel Dieu 1, Place Alexis Ricordeau, 44093, Nantes, France.
authors.forename: Paul-Antoine
authors.initials: PA
authors.lastname: Lehur
authors.affiliation: Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes, Hotel Dieu 1, Place Alexis Ricordeau, 44093, Nantes, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Meurette
keywords: Pelvic floor disorders; Robotic surgery; Ventral mesh rectopexy