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Learning curve analysis of multiport robot-assisted hysterectomy
Yeon Jee Lee1, Dong-Eun Lee2, Hye Rim Oh3
1Center for Gynecologic Cancer, National Cancer Center, Research Institute and Hospital, Goyang, South Korea.
Archives of Gynecology and Obstetrics
|June 29, 2022
Summary
Multiport robot-assisted hysterectomy is a safe procedure with minimal complications. Surgeons achieve proficiency, indicated by decreased operative times, within 23 cases, demonstrating a quick learning curve.
Area of Science:
- Minimally Invasive Surgery
- Gynecologic Oncology
- Surgical Technology
Background:
- Robot-assisted surgery is increasingly adopted in gynecology.
- Evaluating the learning curve is crucial for surgical proficiency and patient safety.
Purpose of the Study:
- To assess surgical outcomes of multiport robot-assisted hysterectomy.
- To determine the learning curve for this surgical approach.
Main Methods:
- Retrospective analysis of 88 patients undergoing multiport robot-assisted hysterectomy.
- Cumulative Summation (CUSUM) technique used to analyze operative, docking, and console times.
- Surgical proficiency assessed through time-based performance phases.
Main Results:
- Median operative time was 120.5 minutes; no conversions to open or laparoscopic surgery.
- Low complication rate (1 umbilical incisional hernia); no transfusions required.
- CUSUM analysis identified three phases: learning (23 cases), competence (36 cases), and mastery (29 cases).
Conclusions:
- Multiport robot-assisted hysterectomy is a safe and effective procedure.
- The learning curve is approximately 23 cases, after which operative times significantly decrease.
- This technique offers minimal postoperative complications and can be rapidly learned by surgeons.
