• Elizabeth D Hermsen, Tim Hinze, Harlan Sayles, Lee Sholtz, and Mark E Rupp.
• Pharmacy Relations and Clinical Decision Support, the Department of Pharmaceutical and Nutrition Care, Nebraska Medical Center, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska 68198-4031, USA. ehermsen@nebraskamed.com
• Infect Control Hosp Epidemiol. 2010 Aug 1; 31 (8): 822-7.

ObjectiveRobot-assisted surgery is minimally invasive and associated with less blood loss and shorter recovery time than open surgery. We aimed to determine the duration of robot-assisted surgical procedures and the incidence of postoperative surgical site infection (SSI) and to compare our data with the SSI incidence for open procedures according to national data.DesignRetrospective cohort study.SettingA 689-bed academic medical center.PatientsAll patients who underwent a surgical procedure with use of a robotic surgical system during the period from 2000-2007.MethodsSSIs were defined and procedure types were classified according to National Healthcare Safety Network criteria. National data for comparison were from 1992-2004. Because of small sample size, procedures were grouped according to surgical site or wound classification.ResultsSixteen SSIs developed after 273 robot-assisted procedures (5.9%). The mean surgical duration was 333.6 minutes. Patients who developed SSI had longer mean surgical duration than did patients who did not (558 vs 318 minutes; P<.001). The prostate and genitourinary group had 5.74 SSIs per 100 robot-assisted procedures (95% confidence interval [CI], 2.81-11.37), compared with 0.85 SSIs per 100 open procedures from national data. The gynecologic group had 10.00 SSIs per 100 procedures (95% CI, 2.79-30.10), compared with 1.72 SSIs per 100 open procedures. The colon and herniorrhaphy groups had 33.33 SSIs per 100 procedures (95% CI, 9.68-70.00) and 37.50 SSIs per 100 procedures (95% CI, 13.68-69.43), respectively, compared with 5.88 and 1.62 SSIs per 100 open procedures from national data. Patients with a clean-contaminated wound developed 6.1 SSIs per 100 procedures (95% CI, 3.5-10.3), compared with 2.59 SSIs per 100 open procedures. No significant differences in SSI rates were found for other groups.ConclusionsIncreased incidence of SSI after some types of robot-assisted surgery compared with traditional open surgery may be related to the learning curve associated with use of the robot.

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