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Robotic telerounding may significantly reduce the length-of-stay of patients undergoing laparoscopic gastric bypass surgery if used to supplement standard postoperative visits, or rounds, made by surgeons.

The study, conducted at Sinai Hospital in Baltimore, Md., evaluated 376 patients who underwent a laparoscopic gastric bypass for morbid obesity. One group of patients (n=284) was assessed by standard bedside physician rounds during the postoperative period. A second group (n=92) was assessed by traditional surgeon bedside visits, supplemented by robotic telerounding.

Patients who suffered from postoperative complications during the same admission were omitted from the study.

The robotic assessment included real-time audio and visual communication with the patient, electronic chart review, and discussion with nursing staff regarding treatment.

The six-foot-tall robot used in the telerounds was equipped with a 15-inch flat screen, two high-resolution cameras, and a microphone, and used a proprietary video conference system to conduct two-way communication with a remote console. During each session, the physician at the control station computer was able to drive the robot to the patients room, emulating an on-site experience.

"We know from previous studies that patient satisfaction was high with robotic telerounding but we wanted to learn if it also could deliver cost savings, and there's no question it does," said Alex Gandsas, MD, FACS, lead author.

Following robotic rounds, 77 percent of patients were discharged on the first postoperative day, whereas none of the patients assessed exclusively by bedside rounds were discharged on day one. The mean length-of-stay was reduced from 2.33 days for the group assessed exclusively by bedside rounds to 1.26 days for the group assessed by robotic telerounding.

Early discharge in the robotic telerounding group created capacity for an addit ional 71 patient/days, representing a total financial gain of 219,578 dollars for 54 occupied beds. In addition, a total room and board savings of 14,378 dollars was realized due to early discharge.




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