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Incidence of Surgical Site Infection Associated with Robotic Surgery

Published online by Cambridge University Press:  02 January 2015

Elizabeth D. Hermsen*
Pharmacy Relations and Clinical Decision Support, Nebraska Medical Center, Omaha, Nebraska Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska Section of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
Tim Hinze
Department of Pharmaceutical and Nutrition Care, Nebraska Medical Center, Omaha, Nebraska
Harlan Sayles
Biostatistics Department, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
Lee Sholtz
Department of Healthcare Epidemiology and Infection Control, Nebraska Medical Center, Omaha, Nebraska
Mark E. Rupp
Section of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
BCPS-ID 984031, Nebraska Medical Center, Omaha, NE 68198-4031 (



Robot-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.


Retrospective cohort study.


A 689-bed academic medical center.


All patients who underwent a surgical procedure with use of a robotic surgical system during the period from 2000-2007.


SSIs 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.


Sixteen 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.


Increased 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.

Original Articles
Copyright © The Society for Healthcare Epidemiology of America 2010

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