| International Session (Symposium) 6 (JSGS・JSGE・JGES) |
| Fri. November 2nd 14:40 - 17:00 Room 13: Kobe International Conference Center International Conference Room |
| Learning curve of robotic rectal surgery with lateral lymph node dissection: cumulative sum and multiple regression analyses | |||
| Kazushige Kawai1, Keisuke Hata1, Hiroaki Nozawa1 | |||
| 1Surgical Oncology, The University of Tokyo | |||
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| Introduction This study aimed to assess the learning curve of robotic rectal surgery, a procedure that has gained increasing focus in recent years because it is expected that the advanced devices used in this approach provide advantages resulting in a shorter learning curve than that of laparoscopic surgery. Methods A total of 131 consecutive patients who underwent robotic rectal surgery by a single surgeon between February 2012 and July 2016 were enrolled. Of these, 41 patients received lateral lymph node dissection. The learning curve for console time was assessed using a cumulative sum analysis and multiple linear regression analysis. Results A cumulative sum plot for console time demonstrated that the learning period could be divided into three phases: Phase I, Cases 1-19; Phase II, Cases 20-78; and Phase III, Cases 79-131. Multiple linear regression analysis indicated that console time decreased significantly from one phase to another (Phase I to II, Δconsole time 83.0 minutes; Phase II to III, Δconsole time 40.1 minutes). Other factors affecting console time included body mass index, operative procedure, and lateral lymph node dissection, but not neoadjuvant therapy (such as chemoradiotherapy) or depth of invasion. Lateral lymph node dissection required an additional 138.4 minutes. Conclusions Our findings suggest that the first phase of the learning curve consists of the first 19 cases, which seems sufficient to master the manipulation of robotic arms and to understand spatial relationships unique to the robotic procedure. |
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Index Term 1: rectal cancer Index Term 2: robotic surgery |
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