{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:00:04Z","timestamp":1785517204712,"version":"3.56.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006183","name":"Faculdade De Medicina De S\u00e3o Jos\u00e9 Do Rio Preto","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006183","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Robotic surgery has become popular in recent decades and is already used in practically all surgical specialties. The increasing use of robotic systems has raised concerns about the safety of patients operated on by surgeons on a learning curve. This demand resulted in a standardized curriculum for training new surgeons. Public hospitals in Brazil possesses robotic systems, making surgical technology available to public healthcare. The relationship between funding and the healthcare model is one of the biggest obstacles to the deployment of expensive new treatments, such as the robotic system. In this prospective study, eighty patients were operated by robotic system, in a Brazilian public hospital, from March 2025 to January 2026, by eight apprentice surgeons. Data concerning demographics, intraoperative information (operation time, and post-operative findings were collected. Patients who underwent surgery were predominantly male (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200948, 60%), with a mean age of 51 years (SD\u2009=\u200915; range: 19\u201381 years). The procedures performed were 39 inguinal hernioplasties (48.75%), followed by 31 cholecystectomies (38.75%) and other procedures accounted for 11 cases. Complications observed included seroma (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20097), median 30\u00a0ml and without any approach required, urinary retention (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092), one infection of surgical site, one case of prolonged pain after hernioplasty and one conversion to open surgery due to complex inguinoscrotal hernia. Part of the financing came from the apprentice surgeon (70% of total cost), part came from the private initiative (20%), embodied in the robotic enterprise system and finally, funding from public healthcare. The median total cost for 5 inguinal hernioplasties and 5 cholecystectomies was 150000,00 reais, Brazilian currency.\n                  <\/jats:p>","DOI":"10.1007\/s11701-026-03645-6","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T08:26:03Z","timestamp":1785313563000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Making robotic surgery viable and training general surgeons in the Brazilian public healthcare"],"prefix":"10.1007","volume":"20","author":[{"given":"Gabriela Gouvea","family":"Silva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Dario","family":"da Silva Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo Tavore","family":"Strasser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heitor Zancheta","family":"de Andrade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Jos\u00e9","family":"Carvalho Tosello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00falio C\u00e9sar","family":"Andr\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaqueline","family":"Venturin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K\u00e1tia Luciana","family":"Franca Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha Vaccari","family":"Grassi Melara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ged\u00e1lia Pettinelli","family":"Tillman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla Buck","family":"de Oliveira Ruiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thaina","family":"de Oliveira Laluce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Ant\u00f4nio","family":"Ribeiro Filho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"issue":"10","key":"3645_CR1","doi-asserted-by":"publisher","first-page":"2550","DOI":"10.1007\/s00268-016-3543-9","volume":"40","author":"T Leal Ghezzi","year":"2016","unstructured":"Leal Ghezzi T, Campos Corleta O (2016) 30 Years of Robotic Surgery. World J Surg 40(10):2550\u20132557. https:\/\/doi.org\/10.1007\/s00268-016-3543-9. PubMed PMID: 27177648","journal-title":"World J Surg"},{"issue":"4","key":"3645_CR2","doi-asserted-by":"publisher","first-page":"2106","DOI":"10.1007\/s00464-017-5908-z","volume":"32","author":"PR Armijo","year":"2018","unstructured":"Armijo PR, Pagkratis S, Boilesen E, Tanner T, Oleynikov D (2018) Growth in robotic-assisted procedures is from conversion of laparoscopic procedures and not from open surgeons\u2019 conversion: a study of trends and costs. Surg Endosc 32(4):2106\u20132113. https:\/\/doi.org\/10.1007\/s00464-017-5908-z","journal-title":"Surg Endosc"},{"key":"3645_CR3","doi-asserted-by":"publisher","unstructured":"Trindade EN, Teixeira ELF, Bortolin VS, Difante LDS, Trindade MRM (2024) Considera\u00e7\u00f5es \u00e9ticas e legais do uso da cirurgia rob\u00f3tica no Brasil. 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The local University Research Ethics Committee (FAMERP- Faculty of Medicine of S\u00e3o Jos\u00e9 do Rio Preto) has confirmed that no ethical approval is required.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors affirm that human research participants provided informed consent for all data in this publication.","order":3,"name":"Ethics","label":"Consent to publish","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"It is financially viable and medically safe to perform robotic surgery in the context of Brazilian public healthcare from a hybrid partnership between private initiative and public resources, resulting in better care and increasing surgical training.","order":4,"name":"Ethics","label":"Interpretation","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Protected material, with signed permission statements from author and publisher.","order":5,"name":"Ethics","label":"Copyright","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"769"}}