Yeon Jee Lee1, Dong-Eun Lee2, Hye Rim Oh3, Hyeong In Ha4, Myong Cheol Lim5,6,7,8. 1. Center for Gynecologic Cancer, National Cancer Center, Research Institute and Hospital, Goyang, South Korea. 2. National Cancer Center, Biostatistics Collaboration Team, Research Institute, Goyang, South Korea. 3. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea. 4. Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Yangsan, South Korea. 5. Center for Gynecologic Cancer, National Cancer Center, Research Institute and Hospital, Goyang, South Korea. mclim@ncc.re.kr. 6. Rare and Pediatric Cancer Branch and Immuno-Oncology Branch, Division of Rare and Refractory Cancer, Research Institute and Center for Clinical Trial, Hospital, National Cancer Center, Goyang, South Korea. mclim@ncc.re.kr. 7. Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea. mclim@ncc.re.kr. 8. National Cancer Center, Center for Gynecologic Cancer and Division of Rare and Refractory Cancer, Research Institute and Hospital, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. mclim@ncc.re.kr.
Abstract
PURPOSE: The purpose of this study was to evaluate the surgical outcomes and learning curve of multiport robot-assisted hysterectomy. METHODS: Eighty-eight patients were identified who underwent multiport robot-assisted surgery for hysterectomy. A retrospective analysis was performed. The cumulative summation technique (CUSUM) was used to investigate the learning curve in surgical proficiency by analyzing total operative, docking, and console times. RESULTS: The patients' median age was 51 years. In addition, the median operative time was 120.5 min (range 56-344 min). The most common indication for surgery was myoma (33.0%). The median estimated blood loss was 30 mL (range 5-200 mL). There was no conversion to laparoscopic or open surgery. No transfusion was required, and only one complication including umbilical incisional hernia was reported. A tendency of decline in total operative time following the first 23 cases was found. The CUSUM graph for total operative time indicated the generation of three distinct performance phases: learning (n = 23), competence (n = 36), and mastery (n = 29). The median docking time was 3 min (range 1-10 min) and median console time was 70 min (range 24-298 min). CONCLUSION: The multiport robot-assisted surgery is an easy and safe procedure with minimal postoperative complications and can be quickly learned. The learning curve was 23 cases to significantly decrease the operative time.
PURPOSE: The purpose of this study was to evaluate the surgical outcomes and learning curve of multiport robot-assisted hysterectomy. METHODS: Eighty-eight patients were identified who underwent multiport robot-assisted surgery for hysterectomy. A retrospective analysis was performed. The cumulative summation technique (CUSUM) was used to investigate the learning curve in surgical proficiency by analyzing total operative, docking, and console times. RESULTS: The patients' median age was 51 years. In addition, the median operative time was 120.5 min (range 56-344 min). The most common indication for surgery was myoma (33.0%). The median estimated blood loss was 30 mL (range 5-200 mL). There was no conversion to laparoscopic or open surgery. No transfusion was required, and only one complication including umbilical incisional hernia was reported. A tendency of decline in total operative time following the first 23 cases was found. The CUSUM graph for total operative time indicated the generation of three distinct performance phases: learning (n = 23), competence (n = 36), and mastery (n = 29). The median docking time was 3 min (range 1-10 min) and median console time was 70 min (range 24-298 min). CONCLUSION: The multiport robot-assisted surgery is an easy and safe procedure with minimal postoperative complications and can be quickly learned. The learning curve was 23 cases to significantly decrease the operative time.
Authors: Georgios Gitas; I Alkatout; L Proppe; L Hanker; L Allahqoli; G Grimbizis; A Rody; N Werner; S Sommer; S Baum Journal: Arch Gynecol Obstet Date: 2021-12-26 Impact factor: 2.493