MSSP450: STATUS OF ROBOTIC-ASSISTED SURGERY (RAS) AND THE EFFECTS OF CORONAVIRUS (COVID-19) ON RAS IN THE DEPARTMENT OF DEFENSE (DOD)
Kayla R Rizzo, DO; Samuel Grasso, DO; Brandon Ford, MD; Alex Myers, DO; Emily Ofstun, MD; Avery Walker, MD; William Beaumont Army Medical Center
Introduction: The purpose of this study is to determine the current use of robotic-assisted surgery (RAS) in the Department of Defense (DoD) compared to the civilian world, and how the coronavirus disease 2019 (COVID-19) pandemic impacted RAS in the DoD. A total of 9,979 RAS cases between 01 October 2017 and 31 December 2020 were reviewed from every DoD Military Treatment Facility (MTF) that meets our inclusion criteria and employs various models of da Vinci robotic surgical systems (Intuitive Surgical). General surgery cases constitute most RAS cases in the DoD, and the civilian sector. The arrival of COVID-19 in the United States significantly decreased the use of RAS in the DoD as well as in the civilian sector in all surgical specialties because it led to postponement or cancellation of many non-emergent surgical procedures.
Materials and Methods: RAS data from the DoD data was obtained from “The Department of Defense Robotic Surgery Dashboard.” This database of information is managed by Ft. Detrick, MD, and it is published quarter-annually to DoD surgeons who are involved with RAS.
Results: There were 3,712 cases performed in 2018, and 4,117 cases performed in 2019, demonstrating a 10.91% increase in RAS use in the DoD. This trend was on the path to continue until COVID-19 when most elective surgeries were postponed starting quarter 2 (Q2) of 2020. The number of RAS cases decreased from 875 cases to 335 cases. This decrease in an upward trend of RAS cases can also be seen in the civilian sector. The number of RAS cases in 2020 were 876,000, demonstrating a 0.79% decrease from 2019 amidst COVID-19. Since the reopening of elective surgical procedures, the DoD has since seen an increase in RAS cases starting at quarter 3 (Q3) 2020. The number of cases increased from 335 during Q2 to 669 during Q3, and again to 755 during quarter 4 (Q4). General surgery continues to be the specialty that performs the most RAS in the DoD since Q4 2015. RAS use in DoD general surgery had an increase in use from 2018-2019 by 28.71%.
Conclusions: In conclusion, the use of RAS in the DoD has continued to increase, and general surgery cases continue to constitute most of these cases. Since the COVID-19 pandemic began, there has been a more significant decline in RAS cases in the DoD compared to the civilian sector.