Impact of surgeon qualifications on the safety of Robot-Assisted surgery

To evaluate how surgeons' experience and qualifications in laparoscopic surgery influence safe implementation of robotic surgery.

We retrospectively reviewed 652 patients with colorectal cancer who underwent robotic surgery between 2016 and 2024 years. The patients were divided into two groups: those who underwent surgery performed by an expert surgeon (expert group, n = 571) and a non-expert surgeon (non-expert group, n = 81). Following propensity score matching (PSM) to minimize the possibility of any selection bias, 81 patients in each group were matched, and the clinical and perioperative features were compared between the two groups.

The number of procedures performed by non-experts has gradually increased over time, and surgeons have become progressively younger. Before matching, the non-expert group had a higher American Society of Anesthesiologists physical status (expert vs. non-expert: 13.6% vs. 4.6%, p < 0.001) and included a higher proportion of colon tumors (36.4% vs. 54.3%, p = 0.002). However, after matching, no differences were observed between the groups. Furthermore, there were no significant differences in the operative time, blood loss, or postoperative complications.

Proctored robotic surgery is considered to be safe. However, when non-expert surgeons perform robotic surgery, expert supervision is desirable.