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ROBOTIC SURGERY START-UP WITH A FELLOW AS THE CONSOLE SURGEON
Susanne REINHARDT, Inge BOETKER IFAOUI and Jorgen THORUP
Rigshospitalet, Paediatric Surgery 4272, Copenhagen, DENMARK
PURPOSE
Certification as DaVinci Robotic console-surgeon for a new starting center requires fulfillment of standard simulator
program including one day training on pigs. First operation is supervised by an experienced visiting robotic console-
surgeon. Also for experienced open/laparoscopic surgeons simulator training is mandatory. Aim of the study was to test
the feasibility of starting up a paediatric urology robotic service using a first year paediatric urology fellow as console-
surgeon though having almost no experience with the open or laparoscopic procedure.
MATERIAL AND METHODS
The operative parameters and clinical outcome of the first 17 robotic anderson-hynes pyeloplasties performed in our
department are presented. In all cases the fellow was the only console-surgeon. An experienced non-robotic paediatric
urologist was at patient site - shifting sitecards, supervising etc. Consecutive data from the previous 5 year-period with
age-matched open(23) and laparoscopic(13) procedures were used for comparison.
RESULTS
Mean total operating time: Open 116 minutes, laparoscopic 254 minutes, robotic 179 minutes (mean console-time 138
minutes (first 9 cases: mean 156 minutes and last 8 cases: mean 117 minutes)). Postoperative mean length of stay:
open 5 days, laparoscopic 4 days, robotic 1 day. For robotic cases a one month postoperative renography showed either
stable or increased functional share of total renal function for the hydronephrotic kidney. Ureteral orifice edema after
double-J removal in on case was the only complication.
CONCLUSIONS
When introducing new robotic technical equipment and skills in paediatric urology it may be proactive for continuity to
invest in fellowship training in favour of senior training. Results were excellent with a short learning-curve.