Association between objective performance indicators and patient outcomes in robotic surgery: a systematic review

Robotic surgery enables automated capture of objective performance indicators (OPIs), which reflect gestures at the surgeon consoles as well as activity at the patient cart. This systematic review evaluated associations between OPIs and clinical outcomes from robotic surgery. Across nine studies, OPIs were associated with various intra-operative and post-operative outcomes, including estimated blood loss, operative time, hospital stay, continence recovery, quality of life, and positive surgical margins. Studies involving predictive models demonstrated improved outcome prediction when combining OPIs with patient and disease characteristics compared to using clinical variables alone. These findings suggest that OPIs provide meaningful data in regard to surgical quality and patient outcomes. Further multicenter research across surgical specialties and robotic platforms is needed to validate the potential utility of OPIs in surgical training, benchmarking, and quality assessment.