With nine new robots, for 52 million euros, the Public Assistance – Hospitals of Paris (AP-HP) becomes the most robotic hospital in Europe. A breakthrough for doctors and patients.

A real technological and cultural shift. While the Paris Public Assistance – Hospitals (AP-HP) has been watching with caution the intrusion of robots into operating theatres, having acquired only four so far, the latest advances made by manufacturers have prompted it to take a giant step forward with the purchase of nine “robot-assisted surgical systems”. Between the devices, the initial training, the maintenance contract, and the expensive “consumables” (parts to be changed, etc.), the AP-HP will make an investment of 52 million euros.

Produced in California by the pioneer and industry leader, Intuitive, these robots, Da Vinci Xi models, look like a large mobile case from which emerge four long articulated arms capable of automatically positioning themselves on the patient according to the intervention. All are associated with a dual workstation dedicated to surgeons. Featuring mini-joysticks, pedals (as on video games), and glasses to immerse yourself in high-resolution and 3D in the patient’s body through cameras. Bluffing!

A seven-year expense

This unprecedented investment, the Hospitals of Paris made it on their own capital and in a very tense financial context. “The expenditure will be spread over seven years,” said François Crémieux, deputy director general of the AP-HP, who welcomed the fact that Europe’s largest hospital “is positioning itself globally as a major player in robotic surgery.”

One of the devices has just been installed in the new outpatient surgery department built at the Pitié-Salpêtrière for non-hospitalized procedures. A first in Europe. Five more robots will be installed by the end of 2018 in Cochin, Georges Pompidou (HEGP), Henri-Mondor, Robert-Debré and Tenon hospitals. Three more will be delivered in early 2019 to Bicêtre, Bichat and St. Louis.

In the long term, thirteen disciplines will benefit: cardiac, colorectal, digestive, hepatobiliary, infantile, plastic, thoracic, visceral, gynaecological, ENT, stomato, urology and adrenal surgery. The nine newcomers will complete 1,600 operations in the first year, and then 3,500 per year in cruising speed.

For patients, the benefits are multiple.

Not only will ap-HP become the hospital group with the most robots in Europe (13), but “it will also have the largest number of medical teams capable of using them,” insists François Crémieux.

For patients, the benefits are multiple. For example, the robot can intervene on organs that are inaccessible in colonoscopy, such as kidney tumours, which previously required opening the patient. As with colonoscopy, four or five small holes are enough to introduce the instruments and camera. “This means less pain for the patient, faster recovery and much more discreet scars,” says Dr. Christophe Vaessen, urologist, and forerunner of robotic surgery at AP-HP, who performs at the Pitié-Salpêtrière.

For doctors, “it’s more comfort and precision: you can chain operations without fatigue, unlike other techniques,” says Professor Morgan Rouprêt, who specializes in urology and oncology. Finally, he says, with robots we will standardize practices which will further improve patient safety.”