An Overview of Robotic Colorectal Surgery Adoption and Training in Brazil

• Published in: Medicina (Kaunas, Lithuania) Vol. 59; no. 9; p. 1675
• Main Authors: Alves Martins, Bruno Augusto, Filho, Oswaldo de Moraes, Ghezzi, Tiago Leal, Melani, Armando Geraldo Franchini, Romagnolo, Luis Gustavo Capochin, Moreira Júnior, Hélio, de Almeida, João Pedro Pereira, Araújo, Sérgio Eduardo Alonso, de Sousa, João Batista, de Almeida, Romulo Medeiros
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.09.2023; MDPI
• Subjects: (MeSH terms): colorectal surgery; Colorectal cancer; Colorectal surgery; Developing countries; Endometriosis; Health care policy; Health disparities; Health facilities; Health insurance; Hospitals; Laparoscopy; LDCs; Medical societies; minimally invasive surgical procedures; Patients; Public health; Robotic surgery; robotic surgical procedures; robotic training; Surgeons; Surgical techniques; Brazil; United States > US
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina59091675

Background and Objectives: Robotic surgical systems have rapidly become integrated into colorectal surgery practice in recent years, particularly for rectal resections, where the advantages of robotic platforms over conventional laparoscopy are more pronounced. However, as with any technological advancement, the initial high costs can be a limiting factor, leading to unequal health service access, especially in middle- and lower-income countries. Materials and Method: A narrative review was conducted with the objective of providing an overview of the escalating adoption, current training programmes, and certification process of robotic colorectal surgery in Brazil. Results: Brazil has witnessed a rapid increase in robotic platforms in recent years. Currently, there are 106 robotic systems installed nationwide. However, approximately 60% of the medical facilities which adopted robotic platforms are in the Southeast region, which is both the most populous and economically prosperous in the country. The Brazilian Society of Coloproctology recently established clear rules for the training programme and certification of colorectal surgeons in robotic surgery. The key components of the training encompass theoretical content, virtual robotic simulation, observation, assistance, and supervised procedures in colorectal surgery. Although the training parameters are well established, no colorectal surgery residency programme in Brazil has yet integrated the teaching and training of robotic surgery into its curriculum. Thus far, the training process has been led by private institutions and the industry. Conclusion: Despite the fast spread of robotic platforms across Brazil, several challenges still need to be addressed to democratise training and promote the widespread use of these platforms. It is crucial to tackle these obstacles to achieve greater integration of robotic technology in colorectal surgery throughout the country.