Ali Akdemir1, Burak Zeybek1, Banu Ozgurel2, Mehmet Kemal Oztekin1, Fatih Sendag3. 1. Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey. 2. Department of Actuarial Sciences, Yasar University, Izmir, Turkey. 3. Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey. Electronic address: fatih.sendag@gmail.com.
Abstract
STUDY OBJECTIVE: To analyze the learning curve of intracorporeal cuff suturing during robotic single-site total hysterectomy. DESIGN: Retrospective study (Canadian Task Force classification II-1). SETTING: University hospital. PATIENTS: Twenty-four patients with benign indications for hysterectomy. INTERVENTIONS: Twenty-four patients who underwent robotic single-site total hysterectomy to treat benign indications were included in the study. Surgical procedures were performed by a single surgeon with extensive experience in laparoscopy, using the single-site platform of the da Vinci Surgical System. All vaginal cuffs were closed intracorporeally using semi-rigid single-site instruments. MEASUREMENTS AND MAIN RESULTS: An exponential learning curve technique was used to analyze the learning curve. The overall mean (SD) vaginal cuff closure time was 23.2 (7) minutes. Learning curve analysis revealed a decrease in vaginal closure time after 14 procedures. CONCLUSIONS: An experienced robotic surgeon requires approximately 14 procedures to achieve proficiency in intracorporeal cuff suturing during robotic single-site total hysterectomy. Novel instruments that create perfect triangulation are needed to overcome the current challenges of suturing and to shorten operative time.
STUDY OBJECTIVE: To analyze the learning curve of intracorporeal cuff suturing during robotic single-site total hysterectomy. DESIGN: Retrospective study (Canadian Task Force classification II-1). SETTING: University hospital. PATIENTS: Twenty-four patients with benign indications for hysterectomy. INTERVENTIONS: Twenty-four patients who underwent robotic single-site total hysterectomy to treat benign indications were included in the study. Surgical procedures were performed by a single surgeon with extensive experience in laparoscopy, using the single-site platform of the da Vinci Surgical System. All vaginal cuffs were closed intracorporeally using semi-rigid single-site instruments. MEASUREMENTS AND MAIN RESULTS: An exponential learning curve technique was used to analyze the learning curve. The overall mean (SD) vaginal cuff closure time was 23.2 (7) minutes. Learning curve analysis revealed a decrease in vaginal closure time after 14 procedures. CONCLUSIONS: An experienced robotic surgeon requires approximately 14 procedures to achieve proficiency in intracorporeal cuff suturing during robotic single-site total hysterectomy. Novel instruments that create perfect triangulation are needed to overcome the current challenges of suturing and to shorten operative time.
Authors: Gaby N Moawad; Paul Tyan; Jiheum Paek; Erryn E Tappy; Daniel Park; Souzanna Choussein; Serene S Srouji; Antonio Gargiulo Journal: J Robot Surg Date: 2019-01-21