Procedure-specific Training for Robot-assisted Distal Pancreatectomy

Area of Science:

• Minimally Invasive Surgery
• Surgical Education
• Health Quality Improvement

Background:

• Robot-assisted distal pancreatectomy (RADP) offers potential benefits over open procedures but lacks robust data on institutional training.
• Implementing new surgical techniques requires effective training programs to ensure quality and safety.

Purpose of the Study:

• To train practicing surgeons in RADP and evaluate its impact on healthcare quality domains.
• To assess the learning curve and clinical efficacy of RADP implementation.

Main Methods:

• Retrospective, single-center cohort study comparing outcomes before and after a procedure-specific RADP training program.
• Analysis included length of stay (LOS), 90-day complication index, and operating time (OT).
• Propensity-score matching compared RADP and open distal pancreatectomy (ODP) outcomes.

Main Results:

• RADP implementation led to decreased blood loss and LOS, with a learning curve showing distinct phases of accumulation, optimization, and steady-state.
• Operating time initially increased but stabilized, and complication rates remained similar.
• Propensity-score matching confirmed reduced LOS and blood loss for RADP compared to ODP.

Conclusions:

• Procedure-specific training facilitates successful RADP adoption by practicing surgeons.
• RADP implementation resulted in immediate improvements in length of stay without adverse effects on safety.
• This training model enhances surgical quality and supports the integration of advanced robotic procedures.