Outcomes of a multicenter training program in robotic pancreatoduodenectomy (LAELAPS-3)

Zwart, M.; Nota, C.; Rooij, Thijs de; Hilst, Jony van; Riele, Wouter te; Santvoort, Hjalmar van; Hagendoorn, Jeroen; Rinkes, Inne Borel; Tran, Khe T. C.; Schelling, George van der; Wijsman, Jan H.; Schreinemakers, Jennifer M. J.; Festen, Sebastiaan; Daams, Freek; Luyer, Misha; Hingh, Ignace de; Mieog, S.; Bonsing, Bert A.; Lips, Daan J.; Hilal, Mohammed Abu; Busch, Olivier R.; Saint‐Marc, Olivier; Zeh, H.; Zureikat, Amer H.; Hogg, Melissa E.; Molenaar, Q.; Besselink, M.; Koerkamp, B. Groot

doi:10.1016/j.pan.2020.07.357

Cited by 15 publications

(18 citation statements)

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“…Nineteen studies used the cumulative sum method (CUSUM) [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] for graphically assessing trends in data. This method illustrates the learning curve by calculating and plotting the difference between the raw data point and the mean value of all the previous data points.…”

Section: Cusum Calculationmentioning

confidence: 99%

“…Thirteen studies were performed retrospectively [10,11,16,17,19,20,24,[27][28][29][30][31][32], 9 studies [8, 12-14, 22, 23, 33-35] were retrospective evaluations of prospectively collected data and the remaining 9 studies were prospective [9,15,21,25,26,[36][37][38]. Fifteen of the studies (50%) analysed the learning curve corresponding to a single surgeon [8,11,13,16,17,21,22,24,26,27,29,33,35,38,39].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Fifteen of the studies (50%) analysed the learning curve corresponding to a single surgeon [8,11,13,16,17,21,22,24,26,27,29,33,35,38,39]. Where indicated, group sizes ranged from 2 to 15 surgeons [12,14,15,19,23,25,31,36]. Five studies presented outcomes pertaining to the learning curve of a team without specifying the number [9,10,20,30,37], and two studies did not explicitly say how many surgeons were involved in the study [28,34].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Zwart et al [25] studied the learning curve in a multicentre (seven) prospective study involving 275 patients and 15 surgeons (all with at least 5 years if experience in open pancreatic surgery and some with LPD experience). The study demonstrated that the CUSUM for operative time reached an inflection point at 22 cases.…”

Section: Robotic Pancreaticoduodenectomy (Rpd)mentioning

confidence: 99%

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Learning curves in minimally invasive pancreatic surgery: a systematic review

Fung

Sha

Kunduzi

et al. 2022

Langenbecks Arch Surg

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Background The learning curve of new surgical procedures has implications for the education, evaluation and subsequent adoption. There is currently no standardised surgical training for those willing to make their first attempts at minimally invasive pancreatic surgery. This study aims to ascertain the learning curve in minimally invasive pancreatic surgery. Methods A systematic search of PubMed, Embase and Web of Science was performed up to March 2021. Studies investigating the number of cases needed to achieve author-declared competency in minimally invasive pancreatic surgery were included. Results In total, 31 original studies fulfilled the inclusion criteria with 2682 patient outcomes being analysed. From these studies, the median learning curve for distal pancreatectomy was reported to have been achieved in 17 cases (10–30) and 23.5 cases (7–40) for laparoscopic and robotic approach respectively. The median learning curve for pancreaticoduodenectomy was reported to have been achieved at 30 cases (4–60) and 36.5 cases (20–80) for a laparoscopic and robotic approach respectively. Mean operative times and estimated blood loss improved in all four surgical procedural groups. Heterogeneity was demonstrated when factoring in the level of surgeon’s experience and patient’s demographic. Conclusions There is currently no gold standard in the evaluation of a learning curve. As a result, derivations are difficult to utilise clinically. Existing literature can serve as a guide for current trainees. More work needs to be done to standardise learning curve assessment in a patient-centred manner.

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Section: Cusum Calculationmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Robotic Pancreaticoduodenectomy (Rpd)mentioning

confidence: 99%

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Learning curves in minimally invasive pancreatic surgery: a systematic review

Fung

Sha

Kunduzi

et al. 2022

Langenbecks Arch Surg

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“…Currently, such training programs are scarce, lack uniformity, and it is unknown whether these training programs are feasible and will lead to beneficial outcomes. In the Netherlands, several training programs )LAELAPS-1, 2, 3) [37][38][39] for minimally invasive pancreatic surgery were shown to be feasible and effective. Based on findings from a nationwide analysis of the implementation and outcomes of MILS in the Netherlands, 40 course on the robotic system and equipment, simulation training with the need to achieve a threshold competence score, several formal case observations during which the surgeon visits an expert liver surgical center and formal clinical training on site with a proctor.…”

Section: J O U R N a L P R E -P R O O F Discussionmentioning

confidence: 99%

Pan-European survey on the implementation of robotic and laparoscopic minimally invasive liver surgery

Zwart

Görgec

Arabiyat

et al. 2022

HPB

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Figures do matter: A literature review of 4587 robotic pancreatic resections and their implications on training

Sandri

Hilal

Dokmak

et al. 2022

J Hepato Biliary Pancreat

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Background:The use of robotic assistance in minimally invasive pancreatic resection is quickly growing. Methods:We present a systematic review of the literature regarding all types of robotic pancreatic resection (RPR). Our aim is to show for which procedures there is enough experience to permit safe training and provide an estimation of how many centers could serve as teaching institutions. Results:Sixty-four studies reporting on 4587 RPRs were analyzed. A total of 2598 pancreatoduodenectomies (PD) were reported by 28 centers from Europe (6/28; 21.4%), the Americas (11/28; 39.3%), and Asia (11/28; 39.3%). Six studies reported >100 robot PD (1694/2598; 65.2%). A total of 1618 distal pancreatectomies (DP) were reported by 29 centers from Europe (10/29; 34.5%), the Americas (10/29; 34.5%), and Asia (9/29; 31%). Five studies reported >100 robotic DP (748/1618; 46.2%). A total of 154 central pancreatectomies were reported by six centers from Europe (1/6; 16.7%), the Americas (2/6; 33.3%), and Asia (3/6; 50%). Only 49 total pancreatectomies were reported. Finally, 168 enucleations were reported in seven studies (with a mean of 15.4 cases per study). A single center reported on 60 enucleations (35.7%). Results of each type of robotic procedure are also presented. Conclusions:Experience with RPR is still quite limited. Despite high case volume not being sufficient to warrant optimal training opportunities, it is certainly a key component of every successful training program and is a major criterion for fellowship accreditation. From this review, it appears that only PD and DP can currently be taught at few institutions worldwide.

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Outcomes of a multicenter training program in robotic pancreatoduodenectomy (LAELAPS-3)

Cited by 15 publications

References 0 publications

Learning curves in minimally invasive pancreatic surgery: a systematic review

Learning curves in minimally invasive pancreatic surgery: a systematic review

Pan-European survey on the implementation of robotic and laparoscopic minimally invasive liver surgery

Figures do matter: A literature review of 4587 robotic pancreatic resections and their implications on training

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