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Retzius-Sparing Robot-Assisted Radical Prostatectomy

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Robotic Proctectomy: Beyond the Initial Learning Curve.

Seth A Rosen¹, Manali Rupji², Yuan Liu²

¹Department of Surgery, Emory University, Atlanta, GA, USA.

The American Surgeon

|December 23, 2022

Summary

This summary is machine-generated.

Robotic proctectomy (RP) shows continued technical progression beyond the initial learning curve. Increased console time and intracorporeal anastomosis indicate growing surgeon expertise and improved outcomes.

Keywords:

colorectal gastrointestinal minimally invasive surgery robotic surgery surgical quality

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Area of Science:

Colorectal Surgery
Surgical Technology
Robotic Surgery

Background:

Limited research exists on technical progression in robotic proctectomy (RP) after the initial learning curve (LC).
Total operating time is a common metric for assessing surgical proficiency.
This study aimed to investigate RP technical progression beyond the initial LC.

Approach:

A retrospective review of 83 robotic proctectomies (RP) for tumor was conducted for a single surgeon (operations 100-550).
Cases were divided into quartiles based on surgeon experience.
Percent console time (PCT) was introduced as a novel metric, defined as console time divided by total operative time (TOT).

Key Points:

No significant differences in demographics, tumor features, or short-term outcomes were observed across experience quartiles.
Increased surgeon experience correlated with significant rises in intracorporeal anastomosis (ICA) rates, total operative time (TOT), and percent console time (PCT).
Complications decreased, and lymph node yield increased with greater surgical experience.

Conclusions:

Intracorporeal anastomosis (ICA) became standard practice in RP post-LC.
Rising TOT and PCT suggest enhanced surgical expertise.
Decreased complications and increased lymph node retrieval indicate improved surgical outcomes with experience.