Postoperative complication rates of surgeons during the supervised training program in robotic-assisted colorectal...

Robotic-assisted surgery (RAS) has established itself as an advanced technique in colorectal surgery, providing better postoperative outcomes due to its greater precision and less invasiveness. However, RAS requires dedicated and supervised training to avoid complications in the initial learning curve. This study evaluated the safety and efficacy of a supervised RAS training program focusing on postoperative complications, and its classification according to the Clavien-Dindo (CD) grade. This is a retrospective, single-center cohort study that included only patients undergoing RAS performed by specialized colorectal surgeons in supervised training. Postoperative complications were evaluated according to the CD classification. A total of 226 patients undergoing different colorectal surgical procedures performed between December 2021 and November 2023 were included. Demographic, clinical, and operative data were collected and compared with the results of previously published studies in order to evaluate the efficacy of supervised training. The median age of patients was 58 years and 58.8% of them were male. The most common surgeries were sigmoidectomy (50%) and rectosigmoidectomy with total mesorectal excision (19%). The overall complication rate was 7.5%, and the most frequent were anastomotic fistulas (2.6%) and intraperitoneal abscesses (1.7%). The mean surgical time was 175 min, and the median hospital stay was three days. According to CD classification 10 patients (4, 4%) developed surgical complications classified as CD III, CD V (0, 4%), CD IV (0.8%), CD I (0.8%), CD II (0, 8%). Patients with complications grade III and IV had significantly longer hospital stay. One patient died (0.4%). The complication rates found were comparable to those reported in the international literature, demonstrating that the risk of complications did not increase during well-structured and supervised training. The risk of perioperative complications during supervised and well-structured training in RAS is similar to those reported in the literature.