DeRAS I – deutsche Situation der robotisch assistierten Chirurgie – eine Online-Survey-Studie

BACKGROUND: Robotic assistance has become established in surgery but is not yet a standard procedure. The current status of clinical dissemination in Germany remains unclear. Industry independent sources are scarce. AIM OF THE WORK: The aim of this survey was to investigate the current status of robotic-assisted surgery (RAS) across specialties in Germany from 2014 to 2018. MATERIAL AND METHODS: An internet search was used to identify hospitals and departments (DP) with access to RAS. The DPs were asked to share their data from 2014–2018. In addition to clinical data, data on utilization, implementation, training, and funding were requested. RESULTS: As of 31 December 2018 RAS was offered at 121 hospitals in Germany, 383 DPs with access to RAS were identified and 26% (n = 98) of DPs responded. On average each DP had two consultant surgeons, 10% of DPs had more than one RAS system and 100% of the RAS systems recorded were from Intuitive Surgical Inc., CA, USA. RAS was implemented in 65% in urology and in 12% in visceral surgery (VS). 21% of programs were interdisciplinary and 4% multidisciplinary (> 3). 83% of systems were purchased and 17% otherwise funded. For additional operating room costs, 74% of hospitals reported paying for them themselves. 14% chose pay as you go. Since 2014, procedures increased by a factor of 4 to approximately 8000. The proportion of VS increased by a factor of 5 since 2016. CONCLUSION: RAS in Germany experienced strong growth through 2018. The range of procedures is similar to that of laparoscopy. With a current lack of reimbursement for the additional technical effort, RAS is predominantly used in the medium and high complexity range. The online survey is a good method to collect independent data without high administrative effort.