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Quality in Robotic Surgery

In robotic surgery, a type of minimally invasive surgery, surgeons make a few small incisions instead of the single larger incision made in open surgery. Using a robotic system, which includes a camera arm and interactive mechanical arms with joints that move much like a human wrist, allows surgeons to perform complex procedures with greater precision, flexibility and control than standard surgical techniques.

When robotic surgery is performed by a certified provider with advanced training and skill, there is usually less blood loss, less trauma to the body and less scarring. Hospital stays are shorter and recovery times much faster than with traditional open surgery. Risks of robotic surgery are similar to those of open surgery, including risk of infection and other complications.

UK HealthCare features the da Vinci® Surgical System. The system’s 3-D imaging and 360-degree instrumentation allow better visibility and improved outcomes over standard minimally invasive surgical techniques.

  • Outcomes

    Outcomes (inpatient only)

    Recent year January 2015-December 2015

    Hospital # of cases Cases with complications % of total cases with complications Mean length of stay Mortality index
    UK HealthCare 144 3 2.08% 3.48 2.08
    All Vizient hospitals 44,505 1,416 3.18% 3.03 0.67

    Outcomes (inpatient and outpatient)

     

    2015

    2012-2015

    Robotic prostatectomy 60 189
    Robotic hysterectomy 96 253
    Robotic hysterectomy and pelvic lymphadenectomy 36 131
    Miscellaneous gynecology 20 85
    Robotic nephrectomy 31 107
    Robotic oral surgery 17 64
    Miscellaneous urology 10 48
    Robotic thoracic surgery 27 69
    Robotic mitral valve repair 2 19
    Robotic colon surgery 0 8
    Total robotic procedures 299 970

    Data from the Vizient, Inc. Clinical Data Base/Resource Manager™ used by permission of Vizient, Inc.. All rights reserved. https://www.vizientinc.com.

    *Vizient, Inc. is an alliance of the nation’s leading nonprofit academic medical centers with 117 academic medical centers and 320 affiliated hospital members.

    **Complications are defined by the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators, AHRQ Pediatric Quality Indicators, Centers for Medicare and Medicaid Hospital Acquired Conditions list, and/or any Vizient, Inc.-defined complication.

  • Understanding the mortality index (lower is better)

    Academic medical centers such as UK HealthCare take care of the very sickest patients. That’s why patient survival rates are adjusted to account for just how sick the patients are when they come to the hospital, considering the seriousness of their illness plus complicating factors like age, obesity, diabetes or heart failure. 

    Observed-to-expected mortality (death) compares two numbers:

    1. Observed mortality is the actual number of patients who died during a particular period. For example, 10 deaths among 1,000 patients would be a rate of 1 percent.

    2. Some people are so sick they are not reasonably expected to survive. More of these patients are seen at places like UK HealthCare because they are better equipped to help. Expected mortality adjusts for how sick patients are compared with patients seen at other hospitals in the United States.

    To reach the final number, the observed rate is divided by the expected rate, meaning that the number of actual deaths is compared to how many people were so sick that they were not expected to live.

    A score of 0.0 means that no patients died.

    A score of 1.00 would mean exactly the same number of patients who might have been expected to die did in fact die.

    A score higher than 1.00 means more patients died than were statistically expected to. For instance, a mortality index of 1.10 would mean 10 percent of people who were expected to survive, did not.

    A score lower than 1.00 means more patients survived than were statistically expected to. For instance, if the ratio is .75, it means that for every 100 people expected to die, only 75 actually did. Twenty-five of those very sick people survived.

    Who figures these rates?

    These rates are figured by UHC. UHC is an alliance of the nation's leading non-profit academic medical centers with 117 academic medical centers and 320 affiliated hospital members. UHC performs risk-adjustment calculations for all hospitals and provides reports to the participating hospitals. These numbers are used by hospitals nationwide.