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An initial experience with 85 consecutive robotic-assisted rectal dissections: improved operating times and lower
John C Byrn1, Jennifer E Hrabe, Mary E Charlton
1Division of Gastrointestinal, Minimally Invasive, and Bariatric Surgery, Departments of Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 4577 JCP, Iowa City, IA, 52242, USA, john-byrn@uiowa.edu.
Surgical Endoscopy
|June 15, 2014
Summary
Robotic-assisted rectal dissections showed improved operating times with a single surgeon. Costs trended downward, suggesting potential long-term savings and a definable learning curve for this surgical approach.
Area of Science:
- Minimally Invasive Surgery
- Surgical Technology
- Colorectal Surgery
Background:
- Limited data exists on robotic platform use in rectal dissections.
- Perception of high cost and steep learning curve for robotic rectal surgery.
Purpose of the Study:
- Assess the learning curve and cost-effectiveness of robotic-assisted rectal dissections.
- Evaluate the impact of surgeon experience on operative efficiency and outcomes.
Main Methods:
- Retrospective review of 85 robotic-assisted rectal dissections by a single surgeon.
- Comparison of the first 43 cases (Time 1) with the subsequent 42 cases (Time 2).
- Analysis of patient demographics, clinicopathologic data, outcomes, and hospital costs.
Main Results:
- Operating times significantly decreased from Time 1 to Time 2 (267 min vs. 224 min, p=0.049).
- Complication and conversion rates did not differ between groups.
- Mean direct hospital costs trended downward, and the observed/expected cost ratio significantly decreased.
Conclusions:
- A significant improvement in operating times was demonstrated with increasing surgeon experience.
- Direct hospital costs showed a downward trend, though not statistically significant.
- Further studies with larger patient cohorts are needed to confirm cost-effectiveness and define the learning curve.
