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Comprehensive Learning Curve of Robotic Surgery: Discovery from a Multicenter Prospective Trial of Robotic Gastrectomy

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dc.contributor.authorKim, MS-
dc.contributor.authorKim, WJ-
dc.contributor.authorHyung, WJ-
dc.contributor.authorKim, HI-
dc.contributor.authorHan, SU-
dc.contributor.authorKim, YW-
dc.contributor.authorRyu, KW-
dc.contributor.authorPark, S-
dc.date.accessioned2023-01-05T03:03:06Z-
dc.date.available2023-01-05T03:03:06Z-
dc.date.issued2021-
dc.identifier.issn0003-4932-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/23612-
dc.description.abstractObjective:To evaluate the complication-based learning curve and identify learning-Associated complications of robotic gastrectomy.Summary Background Data:With the increased popularity of robotic surgery, a sound understanding of the learning curve in the surgical outcome of robotic surgery has taken on great importance. However, a multicenter prospective study analyzing learning-Associated morbidity has never been conducted in robotic gastrectomy.Methods:Data on 502 robotic gastrectomy cases were prospectively collected from 5 surgeons. Risk-Adjusted cumulative sum analysis was applied to visualize the learning curve of robotic gastrectomy on operation time and complications.Results:Twenty-five cases, on average, were needed to overcome complications and operation time-learning curve sufficiently to gain proficiency in 3 surgeons. An additional 23 cases were needed to cross the transitional phase to progress from proficiency to mastery. The moderate complication rate (CD ≥ grade II) was 20% in phase 1 (cases 1-25), 10% in phase 2 (cases 26-65), 26.1% in phase 3 (cases 66-88), and 6.4% in phase 4 (cases 89-125) (P < 0.001). Among diverse complications, CD ≥ grade II intra-Abdominal bleeding (P < 0.001) and abdominal pain (P = 0.01) were identified as major learning-Associated morbidities of robotic gastrectomy. Previous experience on laparoscopic surgery and mode of training influenced progression in the learning curve.Conclusions:This is the first study suggesting that technical immaturity substantially affects the surgical outcomes of robotic gastrectomy and that robotic gastrectomy is a complex procedure with a significant learning curve that has implications for physician training and credentialing.-
dc.language.isoen-
dc.subject.MESHEducation, Medical, Graduate-
dc.subject.MESHGastrectomy-
dc.subject.MESHHumans-
dc.subject.MESHLaparoscopy-
dc.subject.MESHLearning Curve-
dc.subject.MESHOperative Time-
dc.subject.MESHProspective Studies-
dc.subject.MESHRobotic Surgical Procedures-
dc.subject.MESHStomach Neoplasms-
dc.subject.MESHSurgeons-
dc.titleComprehensive Learning Curve of Robotic Surgery: Discovery from a Multicenter Prospective Trial of Robotic Gastrectomy-
dc.typeArticle-
dc.identifier.pmid31503017-
dc.subject.keywordcomplication-
dc.subject.keywordlearning curve-
dc.subject.keywordoperation time-
dc.subject.keywordrobotic gastrectomy-
dc.subject.keywordrobotic surgery-
dc.contributor.affiliatedAuthorHan, SU-
dc.type.localJournal Papers-
dc.identifier.doi10.1097/SLA.0000000000003583-
dc.citation.titleAnnals of surgery-
dc.citation.volume273-
dc.citation.number5-
dc.citation.date2021-
dc.citation.startPage949-
dc.citation.endPage956-
dc.identifier.bibliographicCitationAnnals of surgery, 273(5). : 949-956, 2021-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn1528-1140-
dc.relation.journalidJ000034932-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
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