Learning curve for robotic thyroidectomy using BABA: CUSUM analysis of a single surgeon’s experience

Ouyang, Hui; Xue, Wenbo; Zhang, Zeyu; Cong, Rong; Sun, Botao; Xia, Fada; Li, Xinying

doi:10.3389/fendo.2022.942973

Cited by 11 publications

(8 citation statements)

References 29 publications

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“…Further explanations of the CUSUM method for learning curves have been defined in prior studies. [13][14][15][16] Minimum clinically important difference (MCID) achievement was determined through a comparison of previously established values of 4.5 for Patient-reported Outcomes Measurement Information System Physical Function, 8.1 for SF-12 Physical Component Score, 4.7 for SF-12 Mental Component Score, 4.1 for VAS Arm, 2.6 for VAS Neck, and 8.5 for Neck Disability Index. 17,18 Phases of mastery between demographics, perioperative characteristics, complications, radiographic outcomes, PROs, and MCID achievement were compared through inferential statistics.…”

Section: Discussionmentioning

confidence: 99%

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The Surgical Learning Curve for Cervical Disk Replacement

Federico,

Nie,

Hartman

et al. 2023

Clinical Spine Surgery: A Spine Publication

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Study Design: Retrospective study. Objective: To characterize an experienced single surgeon learning curve for cervical disk replacement (CDR). Summary of Background Data: A single surgeon learning curve has not been established for CDR. Methods: Patients undergoing CDR were included. The cumulative sum of operative time was utilized to separate cases into 3 phases: learning, practicing, and mastery. Demographics, perioperative characteristics, complications, patient-reported outcomes (PROs), and radiographic outcomes were collected preoperatively and up to 1 year postoperatively. PROs included Patient-reported Outcomes Measurement Information System Physical Function, 12-item Short Form-12 Physical Component Score, 12-item Short Form-12 Mental Component Score, visual analog scale (VAS) arm, VAS neck, Neck Disability Index. Radiographic outcomes included segmental angle/segmental range of motion/C2-C7 range of motion. Minimum clinically important difference achievement was determined through a comparison of previously established values. Results: A total of 173 patients were identified, with 14 patients in the learning phase, 42 patients in the practicing phase, and 117 patients in the mastery phase. Mean operative time and mean postoperative day 0 narcotic consumption were significantly higher in the learning phase. The preoperative segmental angle was significantly lower for the learning phase, though these differences were eliminated at the final postoperative time point. Patients in the learning phase reported worse improvement to 6-week postoperative, final postoperative, and worse overall final postoperative VAS Arm scores compared with practicing and mastery phases. Conclusions: For an experienced spine surgeon, the learning phase for CDR was estimated to span 14 patients. During this phase, patients demonstrated longer operative times, higher postoperative narcotic consumption, and worse postoperative VAS Arm scores. Radiographically, no postoperative differences were noted between different phases of mastery. This single surgeon learning curve demonstrates that CDR may be performed safely and with comparable outcomes by experienced spine surgeons despite decreased operative efficiency in the learning phase.

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Section: Discussionmentioning

confidence: 99%

“…The r 2 value was 0.88, indicating a high level of correlation. Further explanations of the CUSUM method for learning curves have been defined in prior studies 13–16 …”

Section: Methodsmentioning

confidence: 99%

The Surgical Learning Curve for Cervical Disk Replacement

Federico,

Nie,

Hartman

et al. 2023

Clinical Spine Surgery: A Spine Publication

View full text Add to dashboard Cite

show abstract

“…In this study, the learning curve was quantitatively evaluated using the cumulative summation (CUSUM) analysis, which was derived from a previous technique [ 9 , 10 ]. The formula utilized in this analysis is as follows: represents the actual operation time for each case, while represents the average operation time for a specific group of patients.…”

Section: Methodsmentioning

confidence: 99%

Application of the suture needle retrograde threading method in scleral fixation of intraocular lenses

Zhou,

Yao,

Huang

et al. 2023

BMC Ophthalmol

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Background Here we described a new threading technique for the universal fixation of any posterior chamber intraocular lens (IOL). Methods Twenty-seven eyes of 27 patients whose surgery done by Surgeon A with the needle-guided method or the suture needle retrograde threading (SNRT) method for intrascleral IOL fixation were enrolled in the first group. Thirty-four eyes of 34 patients whose surgery done by Surgeon A, Surgeon B or Surgeon C with the SNRT method for intrascleral IOL fixation were grouped into three sub-groups by surgeon. Information regarding age, sex, best-available visual acuity (BCVA), intraocular pressure (IOP), past ophthalmological history, threading time (from puncturing to externalizing suture) and complications during and after the surgery were gathered. Results The analysis showed that the threading time was less in the SNRT group than needle-guided group by Surgeon A. There was one eye with suture needle slipping from the guide needle when guiding out of the eye. The threading procedure was completed one time without suture ruptures or loop slippage in the SNRT group operated by Surgeon A. And using the SNRT method, Surgeon A, Surgeon B, and Surgeon C did not show any significant difference in threading time. No complications (e.g., vitreous hemorrhage, hyphemia, retinal detachment, suprachoroidal hemorrhage, or hypotony) were observed during surgery or postoperatively in all cases. No leakage occurred at the site of the puncture after the operation. Conclusions The described technique appears to be a safe, simple, easy-to-learn, and universal surgical method, which is suitable for various types of IOLs.

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“…Artificial intelligence (AI) is widely used in the medical industry [1][2][3]. The development of robotic surgery is aligned with that of minimally invasive and precise surgery [4,5]. The TINAVI orthopedic robotic assist system (also referred to as Ti-robot) is an orthopedic robot independently developed by the Chinese company TINAVI that can be applied to the spine, limb, pelvis, and other parts of the body during surgery, with the characteristics of reduced intraoperative radiation exposure, accurate positioning, and minimally invasive incision [6,7].…”

Section: Introductionmentioning

confidence: 99%

Learning curves for itinerant nurses to master the operation skill of Ti-robot-assisted spinal surgery equipment by CUSUM analysis: A pilot study

Yao,

Wang,

Zhang

et al. 2024

PLoS ONE

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This study aimed to investigate the minimum number of operations required for itinerant nurses in the operating room to master the skills needed to operate the Ti-robot-assisted spinal surgery equipment. Additionally, we aimed to provide a corresponding basis for the development of qualification admission criteria and skill training for nurses who cooperate with this type of surgery. Nine operating room itinerant nurses independently performed Ti-robot equipment simulations using a spine model as a tool, with 16 operations per trainee. Four evaluation indices were recorded: time spent on equipment preparation and line connections, time spent on image acquisition and transmission, time spent on surgical spine screw placement planning, and time spent on robot arm operation. Individual and general learning curves were plotted using cumulative sum analysis. The number of cases in which the slope of the individual learning curves began to decrease was 3–11 cases, and the number of cases in which the slope of the general learning curve began to decrease was 8 cases. The numbers of cases in which the learning curves began to decrease in the four phases were the 5th, 8th, 11th, and 3rd cases. Itinerant nurses required at least eight cases to master the equipment operation skills of Ti-robot-assisted spinal surgery. Among the four phases, the image acquisition and transmission phases and the surgical spine screw placement planning phase were the most difficult and must be emphasized in future training.

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Learning curve for robotic thyroidectomy using BABA: CUSUM analysis of a single surgeon’s experience

Cited by 11 publications

References 29 publications

The Surgical Learning Curve for Cervical Disk Replacement

The Surgical Learning Curve for Cervical Disk Replacement

Application of the suture needle retrograde threading method in scleral fixation of intraocular lenses

Learning curves for itinerant nurses to master the operation skill of Ti-robot-assisted spinal surgery equipment by CUSUM analysis: A pilot study

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