# A Retrospective Study Evaluating the Feasibility and Outcomes of a Robotic-Assisted General Surgery Program in a Nontertiary General Hospital: Insights From Our First 100 Consecutive Cases

## TL;DR

This study shows that robotic-assisted surgery can be safely and effectively implemented in a nontertiary hospital, with good outcomes across 100 procedures.

## Contribution

Demonstrates the feasibility of robotic-assisted surgery in a nontertiary hospital with limited resources.

## Key findings

- Median operative times were 88.5 minutes for minor and 263.0 minutes for major procedures.
- Complication rates were low, with only three conversions to open surgery and one 30-day mortality.
- Median hospital stays were zero days for minor and six days for major procedures.

## Abstract

Introduction

Robotic-assisted surgery (RAS) has transformed minimally invasive surgery by enhancing precision and control. This study evaluates the feasibility and outcomes of introducing a RAS program at a nontertiary hospital, addressing resource and training challenges.

Materials and methods

A retrospective cohort analysis of 100 consecutive RAS procedures performed between December 2023 and September 2024 in the Colorectal Department at The Hillingdon Hospitals NHS Foundation Trust was conducted. Procedures utilized the Intuitive da Vinci Xi Surgical System and involved three senior colorectal consultants.

Results

Patients (median age: 59.0 years, 51 females) underwent 48 minor and 52 major procedures, with cholecystectomy (n = 35) and sigmoidectomy (n = 22) being most common. Median operative times were 88.5 minutes for minor (interquartile range (IQR): 47.3) and 263.0 minutes for major procedures (IQR: 148.8). Median hospital stays were zero days for minor and six days for major procedures. Complication rates were low, with three conversions to open surgery, one Clavien-Dindo grade 3b complication, and one 30-day mortality (major cases only).

Conclusions

The program demonstrated safety and favorable outcomes, even in its early phase, with effective adoption in a resource-limited, nontertiary setting. These results support the feasibility of implementing RAS programs in similar healthcare environments.