Implementing a robotic hepatopancreatobiliary program for new faculty: safety, feasibility and lessons learned

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Robotic Surgery

Background:

• Robotic surgery adoption in hepatopancreatobiliary (HPB) surgery is growing.
• The learning curve presents a significant barrier to widespread implementation.
• Limited data exist on the effectiveness of robotic training in faculty practice.

Purpose of the Study:

• To evaluate the impact of comprehensive robotic training on early practice outcomes in HPB surgery.
• To assess the feasibility and safety of robotic HPB surgery during the initial years of faculty practice.

Main Methods:

• Retrospective review of 137 HPB operations performed by a surgical oncologist in the first three years of practice.
• Surgeon completed comprehensive robotic training during residency and fellowship.
• Analysis of operative times, conversion rates, and major complications (Clavien-Dindo ≥ 3).

Main Results:

• Over 80% of HPB operations were performed robotically annually.
• A low 6% conversion rate was observed across various HPB procedures.
• Median operative times remained consistent and below benchmarks; major complication rates were comparable to published data.

Conclusions:

• Comprehensive robotic training facilitates early proficiency in HPB robotic surgery.
• A dedicated surgical team and prior training are crucial for successful integration into practice.
• Optimized outcomes can be achieved early in a new robotic HPB practice.