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Learning Curve for da Vinci Single-Port Robotic System Cholecystectomy
Niccolò Ramacciotti1, Francesco Celotto2, Federico Pinto3
1Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa.
Summary
Single-port robotic cholecystectomy (SPRC) is safe and feasible. Learning curve analysis shows significant improvements in docking, pre-console, and overall operative times, with stable console times, indicating skill transfer.
Area of Science:
- Minimally invasive surgery
- Robotic surgery
- Surgical education
Background:
- Minimally invasive surgery, particularly cholecystectomy, is the standard of care.
- The da Vinci Single-Port (DVSP) system has renewed interest in single-site surgery since 2018.
- Understanding the learning curve for new surgical techniques is crucial for adoption.
Purpose of the Study:
- To describe the learning curve for single-port robotic cholecystectomy (SPRC).
- To evaluate the impact of experience on operative times and efficiency.
- To assess the feasibility and safety of SPRC.
Main Methods:
- Prospective analysis of 266 consecutive SPRC procedures by a single experienced surgeon.
- Data collection included preoperative, intraoperative, and postoperative variables.
- Cumulative sum (CUSUM) analysis was used to assess learning curve effects on operative times.
Main Results:
- Significant reductions in docking time and pre-console time were observed (P<0.001).
- Overall operation time decreased significantly over the learning phases (P<0.001).
- Surgeon console time remained stable, suggesting efficient skill transfer from prior minimally invasive experience.
Conclusions:
- SPRC is a safe and feasible approach to cholecystectomy.
- The learning curve for SPRC is characterized by improving efficiency in setup and overall procedure time.
- Experience gained in other minimally invasive techniques facilitates proficiency with the DVSP platform.
