title: Diffusion of technology: Trends in robotic-assisted colorectal surgery.
abstract: Following FDA approval, robotic-assisted colorectal surgery (RACS) has increased in prevalence. We aimed to identify trends in utilization and patient characteristics of RACS in the United States using the University HealthSystem Consortium database between October 2011-September 2015. Outcome measures were number and percentage of procedures performed with robotic-assistance. 7100 patients were identified. The most common procedures were low anterior resection, sigmoid colectomy, abdominoperineal resection, right colectomy, rectopexy, left colectomy, and total colectomy. There was a 158% increase in RACS procedures. As a percentage of all approaches, RACS increased from 2.6% to 6.6%. The number of centers performing RACS increased from 105 to 140. Over the study period, the complexity of patients increased, with the percentage of patients with ≥3 comorbidities rising from 18% to 24% (p = 0.03) and patients with a moderate severity of illness score increasing from 35% to 41% (p = 0.04). RACS has expanded significantly in volume, number of centers, and patient selection. Further studies evaluating outcomes and cost of RACS are required to determine whether these increases are justified by improved clinical outcomes.
authors.affiliation: Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: aneel.damle@umassmemorial.org.
authors.forename: Aneel
authors.initials: A
authors.lastname: Damle
authors.affiliation: Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Rachelle N
authors.initials: RN
authors.lastname: Damle
authors.affiliation: Center for Outcomes Research, Department of Surgery, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Flahive
authors.affiliation: Division of Colon and Rectal Surgery, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Schlussel
authors.affiliation: Division of Colon and Rectal Surgery, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Davids
authors.affiliation: Division of Colon and Rectal Surgery, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Sturrock
authors.affiliation: Division of Colon and Rectal Surgery, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Justin A
authors.initials: JA
authors.lastname: Maykel
authors.affiliation: Division of Colon and Rectal Surgery, University of Massachusetts Medical Center, Worcester, MA, USA.
authors.forename: Karim
authors.initials: K
authors.lastname: Alavi
mesh_terms: D003108:Colonic Diseases / Q000601:surgery*; D004059:Diffusion of Innovation; D013505:Digestive System Surgical Procedures / Q000379:methods / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000639:trends*
keywords: Colorectal surgery; Robotics; Trends