Comparison of robotic versus laparoscopic skills: is there a difference in the learning curve?

Yohannes, Paulos; Rotariu, Paul; Pinto, Peter A.; Smith, Arthur D.; Lee, Benjamin R.

doi:10.1016/s0090-4295(02)01717-x

Cited by 325 publications

(193 citation statements)

References 4 publications

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“…Passerotti et al reported that among inexperienced surgeons, the efficiency of suturing using Robot-assisted surgery was operator-independent and required less time to learn [21]. Likewise, Yohannes and Jacobs showed that robotic surgery reduces the learning curve for experienced open surgeons when beginning with robotic approach, compared to conventional laparoscopy [22,23].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic and robotic ureteral stenosis repair: a multi-institutional experience with a long-term follow-up

et al. 2016

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The treatment of ureteral strictures represents a challenge due to the variability of aetiology, site and extension of the stricture; it ranges from an end-to-end anastomosis or reimplantation into the bladder with a Boari flap or Psoas Hitch. Traditionally, these procedures have been done using an open access, but minimally invasive approaches have gained acceptance. The aim of this study is to evaluate the safety and feasibility and perioperative results of minimally invasive surgery for the treatment of ureteral stenosis with a long-term follow-up. Data of 62 laparoscopic (n = 36) and robotic (n = 26) treatments for ureteral stenosis in 9 Italian centers were reviewed. Patients were followed according to the referring center's protocol. Laparoscopic and robotic approaches were compared. All the procedures were completed successfully without open conversion. Average estimated blood loss in the two groups was 91.2 ± 71.9 cc for the laparoscopic and 47.2 ± 32.3 cc for the robotic, respectively (p = 0.004). Mean days of hospitalization were 5.9 ± 2.4 for the laparoscopic group and 7.6 ± 3.4 for the robotic group (p = 0.006).No differences were found in terms of operative time and post-operative complications. After a median followup of 27 months, the robotic group yielded 2 stenosis recurrence, instead the laparoscopic group shows no cases of recurrence (p = 0.091). Minimally invasive approach for ureteral stenosis is safe and feasible. Both robotic and pure laparoscopic approaches may offer good results in terms of perioperative outcomes, low incidence of complications and recurrence.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic and robotic ureteral stenosis repair: a multi-institutional experience with a long-term follow-up

et al. 2016

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“…Potentially, the use of the robotic system enables a larger proportion of pancreatic surgeries to be performed minimally invasively, since the technical benefits of the robot may especially be advantageous in reconstructing anastomoses during a Whipple procedure. Moreover, ergonomics are improved and the use of robotics in minimally invasive surgery potentially shortens the learning curve compared to conventional laparoscopy, as previously shown in different procedures (9,10).…”

Section: Introductionmentioning

confidence: 93%

Developing a robotic pancreas program: the Dutch experience

et al. 2017

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Robot-assisted surgery has been developed to overcome limitations of conventional laparoscopy aiming to further optimize minimally invasive surgery. Despite the fact that robotics already have been widely adopted in urology, gynecology, and several gastro-intestinal procedures, like colorectal surgery, pancreatic surgery lags behind. Due to the complex nature of the procedure, surgeons probably have been hesitant to apply minimally invasive techniques in pancreatic surgery. Nevertheless, the past few years pancreatic surgery has been catching up. An increasing number of procedures are being performed laparoscopically and robotically, despite it being a highly complex procedure with high morbidity and mortality rates. Since the complex nature and extensiveness of the procedure, the start of a robotic pancreatic program should be properly prepared and should comply with several conditions within high-volume centers. Robotic training plays a significant role in the preparation. In this review we discuss the different aspects of preparation when working towards the start of a robotic pancreas program against the background of our nationwide experience in the Netherlands. a 3D, magnified view of the operative field with intraabdominal articulating instruments, thereby increasing surgical dexterity (8). Potentially, the use of the robotic system enables a larger proportion of pancreatic surgeries to be performed minimally invasively, since the technical benefits of the robot may especially be advantageous in reconstructing anastomoses during a Whipple procedure. Moreover, ergonomics are improved and the use of robotics in minimally invasive surgery potentially shortens the learning curve compared to conventional laparoscopy, as previously shown in different procedures (9,10).Still, pancreatic surgery remains highly complex and is associated with significant morbidity and mortality rates (11-13). Therefore, when starting a robotic program for pancreatic surgery, it should be well prepared and several conditions must be met prior to performing the first procedures. Training of a dedicated multidisciplinary team should play a key-role in the setup. However, specific training programs for teams performing robotic pancreatic surgery are still scarce.In the Netherlands, surgeons have been performing laparoscopic pancreatic surgery sporadically for over ten years (1). In 2012, the first robot-assisted distal pancreatectomies were performed and last year the first robot-assisted pancreatoduodenectomies were performed in the University Medical Center Utrecht (UMC Utrecht) after following the University of Pittsburgh Medical Center (UPMC) training program. Next, this program made available nationwide by the Dutch Pancreatic Cancer Group, similar as was done previously for laparoscopic pancreatic surgery (1). Other centers, including the Erasmus Medical Center Rotterdam, recently followed the program. In this review we discuss the steps we took on our road to our first successful robot-assisted pancreatoduodenectomy. T...

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“…Furthermore, performance on the rope-threading task was measured by the time taken to complete the task (i.e., form the P configuration) (as [ 5 ]). The number of repetitions or trials taken to reach the proficiency level demonstrated at immediate retention was used to examine both groups' learning curves for completion time and number of errors.…”

Section: Methodsmentioning

confidence: 99%

“…Additionally, the participants completed a rope-threading task in which they had to pass a rope through a succession of seven pre-specified metal hoops to create a P configuration, using two tools (with their dominant and non-dominant hands). The participants were asked to perform this task as quickly as possible (as [ 5 ]). …”

Section: Surgical System S and Tasksmentioning

confidence: 99%

Robotic technology results in faster and more robust surgical skill acquisition than traditional laparoscopy

et al. 2014

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Official URL: http://dx.doi.org/10.1007/s11701-014-0493-9 DOI: http://dx.doi.org/10.1007/s11701-014-0493-9 EPrint URI: http://eprints.glos.ac.uk/id/eprint/2883 DisclaimerThe University of Gloucestershire has obtained warranties from all depositors as to their title in the material deposited and as to their right to deposit such material.The University of Gloucestershire makes no representation or warranties of commercial utility, title, or fitness for a particular purpose or any other warranty, express or implied in respect of any material deposited.The University of Gloucestershire makes no representation that the use of the materials will not infringe any patent, copyright, trademark or other property or proprietary rights.The University of Gloucestershire accepts no liability for any infringement of intellectual property rights in any material deposited but will remove such material from public view pending investigation in the event of an allegation of any such infringement. We recommend you cite the published (post-print) version.The URL for the published version is http://dx.doi.org/10.1007/s11701-014-0493-9 DisclaimerThe University of Gloucestershire has obtained warranties from all depositors as to their title in the material deposited and as to their right to deposit such material.The University of Gloucestershire makes no representation or warranties of commercial utility, title, or fitness for a particular purpose or any other warranty, express or implied in respect of any material deposited.The University of Gloucestershire makes no representation that the use of the materials will not infringe any patent, copyright, trademark or other property or proprietary rights.The University of Gloucestershire accepts no liability for any infringement of intellectual property rights in any material deposited but will remove such material from public view pending investigation in the event of an allegation of any such infringement. PLEASE SCROLL DOWN FOR TEXT AbstractTechnical surgical skills are said to be acquired quicker on a robotic rather than laparoscopic platform. However, research examining this proposition is scarce. Thus, this study aimed to compare the performance and learning curves of novices acquiring skills using a robotic or laparoscopic system, and to examine if any learning advantages were maintained over time and transferred to more difficult and stressful tasks. Forty novice participants were randomly assigned to either a robotic-or laparoscopic-trained group. Following one baseline trial on a ball pick-and-drop task, participants performed 50 learning trials. Participants then completed an immediate retention trial and a transfer trial on a two-instrument rope-threading task. One month later, participants performed a delayed retention trial and a stressful multi-tasking trial. The results revealed that the robotic-trained group completed the ball pick-and-drop task more quickly and accurately than the laparoscopic-trained group across baseline, immediate retention, and delayed retention tri...

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Comparison of robotic versus laparoscopic skills: is there a difference in the learning curve?

Cited by 325 publications

References 4 publications

Laparoscopic and robotic ureteral stenosis repair: a multi-institutional experience with a long-term follow-up

Laparoscopic and robotic ureteral stenosis repair: a multi-institutional experience with a long-term follow-up

Developing a robotic pancreas program: the Dutch experience

Robotic technology results in faster and more robust surgical skill acquisition than traditional laparoscopy

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