Impact of laparoscopic surgical experience on the learning curve of robotic rectal cancer surgery
- PDF / 979,457 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 19 Downloads / 213 Views
and Other Interventional Techniques
Impact of laparoscopic surgical experience on the learning curve of robotic rectal cancer surgery Gyoung Tae Noh1 · Myunghyun Han1 · Hyuk Hur2 · Seung Hyuk Baik2 · Kang Young Lee2 · Nam Kyu Kim2 · Byung Soh Min2,3 Received: 3 April 2020 / Accepted: 29 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Robotic surgery has advantages in terms of the ergonomic design and expectations of shortening the learning curve, which may reduce the number of patients with adverse outcomes during a surgeon’s learning period. We investigated the differences in the learning curves of robotic surgery and clinical outcomes for rectal cancer among surgeons with differences in their experiences of laparoscopic rectal cancer surgery. Methods Patients who underwent robotic surgery for colorectal cancer were reviewed retrospectively. Patients were divided into five groups by surgeons, and their clinical outcomes were analyzed. The learning curve of each surgeon with different volumes of laparoscopic experience was analyzed using the cumulative sum technique (CUSUM) for operation times, surgical failure (open conversion or anastomosis-related complications), and local failure (positive resection margins or local recurrence within 1 year). Results A total of 662 patients who underwent robotic low anterior resection (LAR) for rectal cancer were included in the analysis. Number of laparoscopic LAR cases performed by surgeon A, B, C, D, and E prior to their first case of robotic surgery were 403, 40, 15, 5, and 0 cases, respectively. Based on CUSUM for operation time, surgeon A, B, C, D, and E’s learning curve periods were 110, 39, 114, 55, and 23 cases, respectively. There were no significant differences in the surgical and oncological outcomes after robotic LAR among the surgeons. Conclusions This study demonstrated the limited impact of laparoscopic surgical experience on the learning curve of robotic rectal cancer surgery, which was greater than previously reported curves. Keywords Learning curve · Robotic surgery · Rectal cancer · Laparoscopic experience Laparoscopic colorectal surgery is an alternative method to open surgery with comparable clinical and oncological outcomes [1–4]. However, in terms of surgical training, it demands a more challenging learning curve to acquire surgical competence. In rectal cancer surgery, the laparoscopic approach requires a higher level of surgical experience and proficiency because of tight work space in * Byung Soh Min [email protected] 1
Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea
2
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
3
Department of Surgery, Severance Hospital, Yonsei University College of Medicine, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul 03722, Korea
the pelvis, limited degrees of movement of rigid laparoscopic instruments, and poor ergonomics for a surgeon during the surgery [5]. According to previous studies, 40–90 surgerie
Data Loading...
