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Is prior laparoscopy experience required for adaptation to robotic rectal surgery?: feasibility of one-step transition from open to robotic surgery.

Authors
 Im-kyung Kim  ;  Jeonghyun Kang  ;  Yoon Ah Park  ;  Nam Kyu Kim  ;  Seung-Kook Sohn  ;  Kang Young Lee 
Citation
 INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, Vol.29(6) : 693-699, 2014 
Journal Title
 INTERNATIONAL JOURNAL OF COLORECTAL DISEASE 
ISSN
 0179-1958 
Issue Date
2014
MeSH
Adult ; Aged ; Colon/surgery ; Colorectal Neoplasms/surgery ; Feasibility Studies ; Female ; Humans ; Laparoscopy/methods* ; Learning Curve* ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery* ; Rectum/surgery ; Retrospective Studies ; Robotics*
Abstract
PURPOSE: The objective of this study is to ascertain the impact of laparoscopic colorectal surgery (LCS) experience on the learning curve of robotic rectal cancer surgery (RRS). Whether LCS experience is mandatory on overcoming the learning curve of RRS or not remains undetermined. METHODS: Before starting the robotic procedure, surgeon A had a limited experience of less than 30 LCS cases, whereas surgeon B had performed more than 300 cases of LCS. From the beginning, 100 consecutive, unselected RRS cases performed by each of the two surgeons were retrospectively analyzed (groups A and B). Perioperative surgical and oncologic outcomes were compared between the two groups. RESULTS: Clinicopathological characteristics between the two groups were similar. One case in group A was converted to open surgery. Mean operation time was shorter in group A than that of group B (272 vs. 344 min, p < 0.001). Overall perioperative morbidity rates were not different between the two groups (17.0 vs. 10.0 %, p = 0.214). There was no difference of circumferential resection margin positivity rate and retrieved lymph node numbers. In group A, the operation time decreased with a steep slope until 17 cases on the moving average curve. The slope in group B maintained a steady state and showed no remarkable changes throughout the study period. CONCLUSIONS: A one-step transition from open to robotic rectal cancer surgery can be achieved without having extensive prior laparoscopic experience.
Full Text
http://link.springer.com/article/10.1007%2Fs00384-014-1858-2
DOI
10.1007/s00384-014-1858-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Jeonghyun(강정현) ORCID logo https://orcid.org/0000-0001-7311-6053
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Im Kyung(김임경) ORCID logo https://orcid.org/0000-0001-8505-5307
Sohn, Seung Kook(손승국)
Lee, Kang Young(이강영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98777
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