Learning curve in robotic liver surgery: easily achievable, evolving from laparoscopic background and team-based

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Robotic Surgery

Background:

• Limited data exists on the learning curve for robotic liver resections.
• This study addresses the need for focused examination of robotic liver surgery learning curves.

Purpose of the Study:

• To assess the learning curve of two surgeons with different laparoscopic backgrounds in robotic liver resections.
• To evaluate the impact of laparoscopic experience on robotic liver surgery proficiency.

Main Methods:

• Cumulative sum (CUSUM) analysis was used to evaluate the learning curve.
• Two surgeons, a Pioneer Surgeon (PS) and a New Generation Surgeon (NGS), were assessed.
• Cases were stratified by complexity: low, intermediate, and high.

Main Results:

• Both surgeons showed a learning curve for operative time, varying by case complexity.
• High-complexity cases revealed learning curves after 10 cases (PS) and 18 cases (NGS).
• A team learning curve effect was observed after 12 cases, highlighting team collaboration benefits.

Conclusions:

• The robotic platform enables a brief learning curve for low and intermediate complexity liver resections.
• Laparoscopic background had minimal impact on the robotic learning curve.
• Team collaboration is crucial for efficient robotic liver surgery outcomes.