Abstract

Introduction: Brazil is the largest country and economy in South America with a population of more than 190 million habitants. In despite of such grandiosity, robotic surgery has been slowly evolving in Brazil since 2008. So far, only 1700 cases have been performed in the whole country for all the specialties. The aim of this article is to explore some of the reasons of this slow growing based on the cardiothoracic and overall experience. Methods: We have analysed the statistics and published national news on the topic of robotic surgery in Brazil. We have delineated some of the main problems that robotic CT surgeons are facing in Brazil nowadays, focusing on our single institution experience within the last 18 months. Results: Since 2008, approximately 1700 robotic surgical cases have been performed in Brazil nationalwide. Of those, 25 were cardiothoracic (CT) cases, encopassing the initial experience in Latin America for robotic lobectomies (4), mitral valves procedures (9), atrial lesion ressection (2), septal repair (4) anterior or posterior mediastinal tumors (4) and, more recently, total endoscopic coronary artery bypass - TECAB (2). The majority of robotic cases nationalwide were done by urology and GI surgery. All these CT cases were performed at the same institution. Brazil has only 4 installed robotic units in private institutions located in the city of São Paulo. However, it is estimated more than 80% of the population served only by the public health system. Conclusions: Cardiothoracic robotic surgery has recently started in Brazil where high profile private hospitals are generally occupied by senior CT surgeons, resistants to perform further training. Robotic units are currently available only at private hospitals in Brazil. Efforts made by a single private academic institution supporting a group of innovative surgeons have enabled the effective beginning of the cardiothoracic robotic program. Our initial results are encouraging other surgeons in private and public hospitals to embrace this endeavour. Recent initiaves on the health system are promising for the future of robotic surgery in Brazil.