Learning curve for single-port robot-assisted colectomy

Abstract

Purpose: Since the introduction of robotic surgery, robots for colorectal cancer have replaced laparoscopic surgery, and a single-port robot (SPR) platform has been launched and is being used to treat patients. We analyzed the learning curve and initial complications of using an SPR platform in colorectal cancer surgery. Methods: We reviewed 39 patients who underwent SPR colectomy from April 2019 to October 2019. All surgeries were performed by the same surgeon using an SPR device. A learning curve was generated using the cumulative sum methodology to assess changes in total operation time (OT), docking time (DT), and surgeon console time (SCT). We grouped the patients into 3 groups according to the time period: the first 11 were phase 1, the next 11 were phase 2, and the last 17 were phase 3. Results: The mean age of the patients was 61.28 ± 13.03 years, and they had a mean body mass index of 23.79 ± 2.86 kg/m 2 . Among the patients, 23 (59.0%) were male, and 16 (41.0%) were female. The average OT was 186.59 ± 51.30 minutes, the average SCT was 95.49 ± 35.33 minutes, and the average DT (time from skin incision to robot docking) was 14.87 ± 10.38 minutes. The SCT differed significantly among the different phases (P < 0.001). Complications occurred in 8 patients: 2 ileus, 2 postoperation hemoglobin changes, 3 urinary retentions, and 1 complicated fluid collection. Conclusion: In our experience, the learning curve for SPR colectomy was achieved after the 18th case.