IDEAL–compliant implementation of the Dexter^® surgical robot in cholecystectomy : A comprehensive framework and clinical outcomes

<strong>Objectives:</strong> The integration of advanced technologies is transforming surgical practice, particularly through robotic systems. This study presents the early clinical implementation of the Dexter^® surgical robot for cholecystectomy and evaluates clinical outcomes using the IDEAL framework.<br /> <strong>Methods:</strong> Twenty patients underwent elective robotic-assisted cholecystectomy using the Dexter^® robot. A thorough implementation process, including rigorous surgeon and nurse training and standardized care protocols, was established. Data on operative metrics, complications, and patient outcomes were analyzed, and patient well-being was assessed via a postoperative phone survey.<br /> <strong>Results:</strong> Six surgeons and thirty nurses were trained, with surgeons completing a minimum of 20 h of simulation. Preoperative and operative times were significantly reduced through this process. Comparing the first 10 operations to the second, docking time decreased from 11.4 ± 4.1 min to 7.1 ± 2.1 min (p=0.0144) and operative time improved from 130.5 ± 25.7 min to 99.7 ± 21.8 min (p=0.0134). Mean intraoperative blood loss was minimal, averaging 19.5 ± 31.4 mL, and the average length of hospital stay was 3.1 ± 1.4 days. Postoperative pain levels were low, and patient satisfaction was high, as assessed by telephone survey.<br /> <strong>Conclusions:</strong> Our findings highlight the value of the IDEAL framework in guiding the systematic evaluation and implementation of new surgical technologies such as the Dexter^® robot. A structured approach is essential to improve patient outcomes and safety in the coming digital transformation of surgery.