Robotic Emergency General Surgery Program

Beginning of Robotic Emergency General Surgery Program at Nice University Hospital

Background Abdominal surgical emergencies account for 20-30% of visceral surgery procedures. However, these emergencies are responsible for more than half of the morbidity in our discipline, with a surgical site infection rate four times higher than in elective surgery, and significantly higher rates of surgical revision and conversion (PMID: 34225343 and 27016997 and 27120712). In cases where minimally invasive surgery is converted to laparotomy, patients are three times more likely to be admitted to critical care units (PMID: 39966134). Visceral surgery currently represents the largest and fastest-growing discipline in robotic surgery. Robotic management of emergency general surgery has been described in the literature for several years, particularly in the United States. Robotic surgery allows a shift from open procedures to minimally invasive techniques or simplifies complex laparoscopic procedures. Several literature reviews and meta-analyses report decreased laparotomy rates, reduced perioperative morbidity, and shorter average length of hospital stay (PMID: 38446451 and 38918109). Abdominal surgical emergencies account for 20-30% of visceral surgery procedures. However, these emergencies are responsible for more than half of the morbidity in our discipline, with a surgical site infection rate four times higher than in elective surgery, and significantly higher rates of surgical revision and conversion (PMID: 34225343 and 27016997 and 27120712). In cases where minimally invasive surgery is converted to laparotomy, patients are three times more likely to be admitted to critical care units (PMID: 39966134). Visceral surgery currently represents the largest and fastest-growing discipline in robotic surgery. Robotic management of emergency general surgery has been described in the literature for several years, particularly in the United States. Robotic surgery allows a shift from open procedures to minimally invasive techniques or simplifies complex laparoscopic procedures. Several literature reviews and meta-analyses report decreased laparotomy rates, reduced perioperative morbidity, and shorter average length of hospital stay (PMID: 38446451 and 38918109).Primary Objective:To assess the implementation of a robotic surgery program for emergency visceral procedures (proof of feasibility in our university hospital). Secondary Objectives: Reduce perioperative morbidity, Reduce the rate of laparotomy, Reduce the average length of hospital stay (LOS), Reduce postoperative admission to critical care, Reduce operative time.

Study Overview

• Status: Not yet recruiting
• Conditions: Emergency General Surgery
• Intervention / Treatment: Procedure: Emergency General surgery patients with robotic approach for the surgery

• Study Type: Observational
• Enrollment (Estimated): 30

Contacts and Locations

• Study Contact: Name: Damien Massalou; Phone Number: Massalou; Email: massalou.d@chu-nice.fr

Study Locations

• France
  • Alpes Maritimes
    • Nice, Alpes Maritimes, France, 06000
      • CHU de Nice
      • Contact: Damien Massalou; Phone Number: + 33 04 92 03 22 63; Email: massalou.d@chu-nice.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Emergency general surgery patients admitted to Nice University Hospital.

Description

Inclusion Criteria:

• Acute cholecystitis with predictors of intraoperative difficulty.
• Bowel obstruction requiring bowel resection (in presence of CT signs of visceral compromise: poor enhancement of bowel loops, pneumoperitoneum).
• Complicated acute diverticulitis with perforation and peritonitis.
• Penetrating abdominal trauma with hemodynamic stability requiring surgery (e.g., bowel resection-anastomosis).
• Right or left colectomy for other etiologies.
• Splenectomy in hemodynamically stable or embolized patients.

Exclusion Criteria:

• Hemodynamic instability.
• Uncomplicated acute appendicitis.
• Acute cholecystitis without predictors of intraoperative difficulty.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Implementation of a robotic surgery program for emergency visceral procedures	To assess the implementation of a robotic surgery program for emergency visceral procedures (proof of feasibility in our university hospital).The team will screen patients who will meet the inclusion criteria and the first score will be : were we able to purpose robotic approach fr the patient. Then if we were able to do it, and if not, the reason why (OT nurse difficulty ? technical issue ? other ?).	Postoperative day 30

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluating robotic general emergencies procedures (Change perioperative morbidity)	Clavien-Dindo Classification ( grade 1 to 5) vs an historical cohort	Postoperative day 30.
Evaluating robotic general emergencies procedures (Change the rate of laparotomy)	Pourcentage vs historical data	Postoperative day 30
Evaluating robotic general emergencies procedures (Change the average length of hospital stay )	(LOS)-(in days, vs historical data)	Postoperative day 30
Evaluating robotic general emergencies procedures (Change postoperative admission to critical care)	Pourcentage vs historical data	Postoperative day 30
Evaluating robotic general emergencies procedures (Change operative time)	In minutes, vs historical data	Postoperative day 30

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire de Nice

Study record dates

Study Major Dates

• Study Start (Estimated): January 1, 2026
• Primary Completion (Estimated): November 30, 2027
• Study Completion (Estimated): December 31, 2027

Study Registration Dates

• First Submitted: September 19, 2025
• First Submitted That Met QC Criteria: September 29, 2025
• First Posted (Estimated): October 1, 2025

Study Record Updates

• Last Update Posted (Estimated): October 1, 2025
• Last Update Submitted That Met QC Criteria: September 29, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: 25Urgences01

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No