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P048: PATIENT PERCEPTIONS AND PREFERENCES REGARDING ROBOTIC SURGERY AND ASSOCIATED ENVIRONMENTAL IMPACT
Joseph M Blankush; Sriram Cyr; Albert Kim; Monica Polcz; Joan Kaiser; Jose Diaz; Myrick Shinall; Meredith Duke; Richard A Pierce; Joseph R Broucek; Vanderbilt University Medical Center
INTRODUCTION: Robotic techniques are increasingly presented to patients as alternative approaches to open surgery. While the body of research examining the comparative outcomes of open and robotic surgery seemingly grows by the month, little research has been completed examining patient perceptions of robotic surgery, especially in general surgery literature. Meanwhile, 38% of U.S. adults view climate change as an ongoing crisis while 81% believe human activity is a primary driver of climate change. The WHO estimates that by 2030, an incremental 250,000 deaths will be attributable to climate change, and recent analysis demonstrates that the global healthcare sector generates 4.4% of global CO2 emissions, enough to be the 5th largest emitter if considered an independent nation. In this context, an understanding of patients’ perceptions and preferences regarding robotic surgery and climate change could aid surgeons in identifying gaps in patients’ knowledge of robotic surgery while tailoring surgical offerings to drive value-based healthcare beyond the financial calculus.
METHODS: Following IRB approval, patients presenting to a general surgery hernia clinic were asked to complete an optional, anonymous survey. A multi-disciplinary team of “environmedical” health experts was created and included in survey creation. A visual analog scale was used for all non-demographic or surgical history questions. Analysis was completed using Microsoft Excel and SPSS statistical software.
RESULTS: Of patients surveyed, 62% had previously undergone abdominal surgery but only 8% had undergone robotic surgery of any kind. 54% of patients agreed that they understood the difference between traditional open surgery and robotic surgery. Patients who had undergone previous abdominal surgery were more likely to feel they understood the difference between open and robotic surgery. 54% of patients felt that robotic surgery requires more technical skill than open surgery, and the remaining 46% felt that skill requirements were equal. All patients felt that robotic surgery either had the same or better outcomes in terms of durability of hernia repair. 50% felt that open surgery was associated with more pain than robotic surgery while only 8% felt that robotic surgery was more painful. 50% felt that open surgery had a higher complication rate while 8% indicated robotic surgery had more complications. 54% indicated that if given the choice, they would prefer robotic surgery over open surgery while 46% were neutral. 77% of patients believe that climate change is happening today, and the same percentage indicated they felt human activities are a cause of climate change. When asked if their preference for open surgery would change if open surgery were found to have less environmental impact than robotic surgery, patients demonstrated a 49% increase in the likelihood that they would elect to undergo open surgery.
CONCLUSION: Survey responses to date indicate a favorable patient perception of robotic surgery. Responses also suggests that climate change is a concern for many patients, and data regarding the relative environmental impact of open and robotic surgery may influence patients’ surgical preferences.
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