Introduction and Problems of Robot-Assisted Surgery for Colorectal Cancer During the Covid-19 Pandemic in Japan: A Single-Institution Experience

Introduction The colorectal robot-assisted surgery acquired insurance coverage in 2018, and its demand has increased significantly in Japan. The introduction of robot-assisted surgery should follow guidelines led by the Japanese Society for Endoscopic Surgery (JSES). The requirements are wide-ranging, including acquisition of certification through training courses, visits to other facilities by the medical team, necessity of inviting proctors, and acquisition of facility conditions. However, introducing robotassisted surgery in accordance with these guidelines is not easy during COVID-19 pandemic. Methods We considered the current situation and problems in our department, which recently introduced robot-assisted colorectal surgery. Furthermore, we examined the problems associated with introduction of robot-assisted surgery in Japan. Results In our department, there was no doctor with experience in robot-assisted surgery, so we started by obtaining the certificates of operator and assistant. Due to the impact of the COVID-19 pandemic, there was a reservation limit for the certificate acquisition program, which caused a delay in taking the course. In addition, it was difficult to observe the operation as a team due to the number of people at the receiving hospital and the COVID-19 infection of the operating room staff in our hospital. At proctor, events such as the outbreak of COVID-19 clusters at the workplace of the invited doctor caused the schedule to be canceled suddenly. Conclusion In anticipation of future infectious disease outbreaks similar to the COVID-19 pandemic, it is important to establish a system that can easily and smoothly introduce robot-assisted surgery in Japan.