The learning curves of robotic and three-dimensional laparoscopic surgery in cervical cancer

Abstract

BACKGROUND: The 3D laparoscopy systems and robotic systems have been introduced into clinical practice for a few years. But the comparison of robotic and 3D laparoscopic gynecologic surgery is still needed.OBJECTIVE: To retrospectively compare the learning curves of robotic and 3D laparoscopic hysterectomy and pelvic lymphadenectomy in cervical cancer.STUDY DESIGN: The operational duration, blood loss, peritoneal drainage of first 24 hours after operation, total hospitalization days, hospitalization days after operation, lymph nodes collected, learning curves and cost of robotic and 3D laparoscopic hysterectomy and pelvic lymphadenectomy in cervical cancer performed by one experienced surgeon were studied.RESULTS: There was one surgeon who performed 37 cases of robotic and 24 cases of 3D laparoscopic hysterectomy and pelvic lymphadenectomy, and the turning point of learning curves was case 13th and case 10th. The differences of duration of operation, blood loss, peritoneal drainage of first 24 hours after operation, total hospitalization days, hospitalization days after operation, lymph nodes collected and perioperative complications were not statistically significant. But the cost of each robotic operation was higher than 3D operation.CONCLUSIONS: The turning point of the learning curve of 3D laparoscopic hysterectomy and pelvic lymphadenectomy is earlier than that of robotic sugery in patients with cervical cancer, and there is no obvious benefit from robotic surgery than 3D surgery in the terms of short-term medical index and hospitalization cost.

Tips and Details for Successful Robotic Myomectomy: Single-Center Experience with the First 125 Cases

“…Some studies have shown that even surgeons without laparoscopic operation experience can master robot-assisted surgery techniques [ 52 ]. Compared with laparoscopy, robot-assisted surgery is easier to operate, can significantly reduce the difficulty of surgery, shorten the learning curve, and greatly reduce the operating pressure and burden of the operator [ 53 ]. These advantages cannot be simply explained by statistics.…”

The Effect of Laparoscopic Radical Hysterectomy Surgical Volume on Oncology Outcomes in Early-Stage Cervical Cancer

“…In general, theoretical and practical research results confirm that laparoscopic surgery skills can be improved with an increase in surgical volume. Many previous learning curve studies of LRH have proved it (16)(17)(18). A meta-analysis to investigate the relationship between the number of gynecology surgeries and surgical outcomes has been conducted, and it is believed that intraoperative and postoperative complications are significantly reduced with high-volume surgeons (27).…”

“…So, the surgical experience of surgeons may be one of the reasons influencing the oncology outcomes of LRH (13)(14)(15). However, there are limited data specifically analyzing the impact of the experience of surgeons in LRH, and most of their main concern was surgical skills or shortterm effects (16)(17)(18), and little concentration was focused on long-term survival outcomes. Most of these studies involved single centers and surgeons, with few cases included (17,19,20).…”

Can Reinforcement Learning Be Applied to Surgery?

“…In addition, increasing the playable area provides significantly more options for actions, and high-performance computers and tuning of neural networks will be needed for more complex tasks. 3D operation models are currently being developed and are used in Artificial Intelligence -Emerging Trends and Applications practice for endoscopic surgery simulation [11][12][13][14]. The speed at which high-performance…”