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Defining the learning curve for robotic-assisted esophagogastrectomy
Jonathan M Hernandez1, Francesca Dimou, Jill Weber
1Department of Surgery, University of South Florida, Tampa, FL, USA.
Summary
Robotic-assisted esophagogastrectomy shows a learning curve for surgeons, with proficiency near 20 cases. Operative times improved significantly, and complication rates remained low and stable throughout the study.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Robotic Surgery
Background:
- Robotic-assisted surgery is expanding rapidly, especially for complex esophageal procedures.
- The learning curve for robotic-assisted esophagogastrectomy is not well-defined.
- Understanding this learning curve is crucial for patient safety and surgical efficiency.
Purpose of the Study:
- To define the learning curve for robotic-assisted esophagogastrectomy.
- To assess the impact of experience on operative time, conversion rates, and patient safety.
- To establish benchmarks for surgical proficiency in this technique.
Main Methods:
- Prospective follow-up of patients undergoing robotic-assisted esophagogastrectomy.
- Comparison of operations performed by a single surgeon in successive 10-patient cohorts.
- Analysis of operative times, conversion rates, and complication rates using Spearman regression and Mann-Whitney U tests.
Main Results:
- A significant reduction in operative times was observed after 20 cases (p <0.005).
- No conversions to open thoracotomy were required during the study.
- Complication rates were low and did not significantly differ between cohorts, with no complications in the final cohort.
Conclusions:
- The learning curve for robotic-assisted esophagogastrectomy approaches proficiency around 20 cases for experienced minimally invasive surgeons.
- Operative complications and conversion rates were infrequent and consistent across patient cohorts.
- Robotic-assisted esophagogastrectomy is a safe and effective procedure with a manageable learning curve.
