Does Prior Laparoscopic and Open Surgery Experience Have Any Impact on Learning Curve in Transition to Robotic Surgery?

Adayener, Cüneyt; Okutucu, Tolga Muharrem; Uygur, Cemil

doi:10.4274/jus.1096

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…For example, the influence of experience in open surgery on the learning in laparoscopic surgery is probably overestimated, but experience in a similar skill (e.g., laparoscopic for robotic surgery) can be a good predictor for a faster skill acquisition. 3,19 Often expertise in one procedure via one modality may allow a quicker uptake of a newer modality due to the intrinsic knowledge of the mastered procedure. Validation of this concept is however scarce.…”

Section: Experiencementioning

confidence: 99%

“…Some published data looking at time line outcomes for surgeons adopting a minimally invasive technique show some evidence of a shortened proficiency gain curve with higher frequency. 3,5,19 Hence, access and rate of according procedures in the normal environment of a prospective delegate may be considered as a selection criterion. Furthermore, the proficiency gain curve for each delegate is variable and for industry to support a minimum of say five proctored sessions may make a delegate alienated for the 6th procedure.…”

Section: Access and Exposurementioning

confidence: 99%

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Proctorship in Minimally Invasive Colorectal Surgery

Zahid

Mišković

2021

Clin Colon Rectal Surg

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Teaching an established surgeon in a novel technique by a colleague who has acquired a level of expertise is often referred to as “proctoring” or “precepting.” Surgical preceptorships can be defined as supervised teaching programs, whereby individual or groups of surgeons (proctors) experienced in a certain technique support a colleague who wants to adopt this technique (sometimes referred to as “delegates” or “preceptees”). Preceptorship programs really focus on a specific technique, technology, or skill which is required to broaden, complement, or transform an established surgeon's practice.Within colorectal surgery, in the past 30 years, there is been an evolution of interventional options including open, laparoscopic, robotic, and endoscopic procedures. With each new emerging technology and technique, safe and effective uptake by established surgeons is best been attained by a period of proctorship by an experienced colleague. Formalizing this has been facilitated largely through industry support. There, however, remains a considerable chasm when it comes to standardization, quality control, and jurisprudence.This article aims to describe the requirements for a contemporary proctorship program, to examine instruments of quality control, and how to improve effectiveness.

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Section: Experiencementioning

confidence: 99%

Section: Access and Exposurementioning

confidence: 99%

Proctorship in Minimally Invasive Colorectal Surgery

Zahid

Mišković

2021

Clin Colon Rectal Surg

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“…For surgeons who are experienced in complex open surgery, transition to the robotic platform is generally easier than learning advanced laparoscopic skills, especially for complex technical suturing as required in a PD. 18 While surgeons may find it easier to develop a robotic skill set than to learn complex advanced laparoscopic techniques, the challenge in expanding a robotic program to a new institution may be due to the significant cost of acquiring the robotic platforms. In addition, successful use of robotic surgery platforms, especially for advanced cases requires trained staff who are familiar with the technology.…”

Section: Discussionmentioning

confidence: 99%

Learning Curve of a Laparoscopic Pancreaticoduodenectomy Program at a Second Institution

Martin,

Bonds,

Fischer

et al. 2024

The American Surgeon™

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Background Historically, pancreaticoduodenectomy (PD) has been performed via a laparotomy, but increasingly, laparoscopic and robotic platforms are being employed for PD. Laparoscopic PD has a steep surgeon specific learning curve and programmatic elements that must be optimized. These factors may limit a surgeon who is proficient at laparoscopic PD to develop a program at another institution. We hypothesize that the learning curve for a surgeon transferring a program to a second institution is shorter than the initial laparoscopic PD learning curve for the same surgeon. Methods A retrospective review of patients who underwent laparoscopic PD for any indication at the first institution (FI) from 2012 to 2017 and the second institution (SI) from 2018 to 2021 was conducted. Standard statistical analysis was performed. The learning curve was identified using one-sided CUSUM analysis of operative times. Result We identified 110 participants, 90 from the FI and 20 from the SI. More patients at the FI were diagnosed with periampullary adenocarcinoma on final pathology compared to the SI (65.6% vs 40.0%, P = .0132). FI operative times stabilized after the 25th laparoscopic PD and SI operative times stabilized after the 5th operation. No statistically significant difference was identified in postoperative complications. Conclusions The learning curve and average operative time of an SI laparoscopic PD program was shorter than the initial learning curve for a single surgeon with comparable outcomes. This suggests that complex minimally invasive surgical programs can be safely transferred to another high-volume institution without significant loss of progress.

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Does Prior Laparoscopic and Open Surgery Experience Have Any Impact on Learning Curve in Transition to Robotic Surgery?

Cited by 2 publications

References 22 publications

Proctorship in Minimally Invasive Colorectal Surgery

Proctorship in Minimally Invasive Colorectal Surgery

Learning Curve of a Laparoscopic Pancreaticoduodenectomy Program at a Second Institution

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