Can proctoring affect the learning curve of robotic-assisted laparoscopic pyeloplasty? Experience at a high-volume pediatric robotic surgery center
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- 作者：Diana K. Bowen ; Bruce W. Lindgren ; Earl Y. Cheng…
- 关键词：Proctoring ; Robotic ; assisted laparoscopic pyeloplasty ; Learning curve ; Robotics
- 刊名：Journal of Robotic Surgery
- 出版年：2017
- 出版时间：March 2017
- 年：2017
- 卷：11
- 期：1
- 页码：63-67
- 全文大小：
- 刊物主题：Minimally Invasive Surgery; Surgery; Urology;
- 出版者：Springer London
- ISSN：1863-2491
- 卷排序：11
文摘
We sought to determine if the learning curve in pediatric robotic-assisted laparoscopic pyeloplasty (RALP) for an experienced open surgeon (OS) converting to robotics would be affected by proctoring from an experienced robotic surgeon (RS), and/or the experience of training within the framework of an established robotics program. We reviewed pediatric RALP cases by three surgeons at our institution, including the OS, RS, and a new fellowship-trained surgeon (FTS). We compared the first eight independent RALPs for the OS with the most recent ten RALPs for the RS. As an ancillary analysis, to isolate the impact of proctoring and of a robotics program, we reviewed the first ten cases of the FTS as well the first and last eight cases of the RS at a prior institution. A total of 44 patient charts were reviewed, with a mean follow-up time of 16 months (range 6.7–45 months). Radiologic improvement was seen in all patients with the exception of one who required reoperative pyeloplasty. The FTS, RS, and OS had similar mean operative times; however; when comparing robotic cases at the beginning of each of their learning curves, shorter operative times were achieved by the proctored surgeon (OS). Finally, comparing two RALP cohorts by the RS at his prior institution revealed longer operative times with an inexperienced robotics team. We demonstrate that an experienced open surgeon and fellowship-trained surgeon can quickly attain levels of expertise with pediatric RALP within an established robotic surgical program.