Robotic colorectal surgery in Australia: evolution over a decade

• Published in: ANZ journal of surgery Vol. 91; no. 11; pp. 2330 - 2336
• Main Authors: Larach, José Tomás, Flynn, Julie, Kong, Joseph, Waters, Peadar S., McCormick, Jacob J., Murphy, Declan, Stevenson, Andrew, Warrier, Satish K., Heriot, Alexander G.
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01-11-2021; Blackwell Publishing Ltd
• Subjects: Colorectal surgery; Correlation analysis; Government investment; Government programs; Private sector; Rectum; robotic colorectal surgery; robotic low anterior resection; robotic rectopexy; robotic right hemicolectomy; Robotic surgery; Robotics; Trends; Australia; robotic rectopexy; robotic right hemicolectomy; robotic colorectal surgery; robotic low anterior resection; robotic surgery
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1111/ans.16554

Background
Despite reports of increasing adoption of robotics in colorectal surgery worldwide, data regarding its uptake in Australasia are lacking. This study examines the trends of robotic colorectal surgery in Australia during the last 10 years.
Methods
Data from patients undergoing robotic colorectal surgery with the da Vinci robotic platform between 2010 and 2019 were obtained. Overall, numbers of specific colorectal procedures across Australia were obtained from the Medicare Benefit Schedule data over the same period. Pearson's correlation analysis was used to determine the statistical trends of overall and specific robotic colorectal procedures over time.
Results
A total of 6110 robotic general surgery procedures were performed across Australia during the study period. Of these, 3522 (57.6%) were robotic colorectal procedures. An increasing trend of overall robotic colorectal procedures was seen over 10 years (Pearson's coefficient of 0.875; P = 0.001). While this applied to both the public and private sectors, 90.7% of the procedures were undertaken in the private sector. Restorative rectal resections, rectopexies, and right hemicolectomies accounted for 82.6% of the robotic colorectal procedures performed during this period with an increasing trend seen over time for each intervention. Moreover, a robotic approach was utilized in 12.5%, 41.0% and 9.0% of all restorative rectal resections, rectopexies and right hemicolectomies undertaken in Australia during 2019, respectively.
Conclusion
Robotic colorectal surgery has increased dramatically in Australia over the last 10 years, especially in the private sector. Penetration of robotic colorectal surgery in the public healthcare system will require focussed cost–benefit evaluations and governmental investment.
While the adoption of robotic colorectal surgery has increased internationally, data regarding its uptake in Australia are lacking. This study demonstrates the increasing trends of robotic colorectal surgery in Australia over the last 10 years.