Learning Curve Analysis of Single-Site Robot-Assisted Hysterectomy

• Published in: Journal of clinical medicine Vol. 11; no. 5; p. 1378
• Main Authors: Lee, Yeon Jee, Lee, Dong-Eun, Bae, Jaekyung, Ha, Hyeong In, Lim, Myong Cheol
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02.03.2022; MDPI
• Subjects: Abdominal surgery; Body mass index; Cellular biology; Chronic illnesses; Clinical medicine; Gynecology; Hospitals; Hysterectomy; Laparoscopy; Laparotomy; Pain; Patients; Regression analysis; Robotic surgery; Skills; Surgical outcomes; Variables; CUSUM graph; hysterectomy; learning curve; robotic surgery
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm11051378

We aim to analyze the surgical outcomes and learning curve of single-site robot-assisted hysterectomy. This was a retrospective cohort study from a single academic medical center. A total of 123 patients who underwent single-site robotic surgery for gynecologic disease were enrolled. Gynecologic surgeries were performed by a single surgeon using single-site robot-assisted hysterectomy. The median age of enrolled patients was 49 years (range: 30-74 years). The median operation time was 131 min (range: 59-502 min) and the median docking time was 3 min (range: 1-10 min). In addition, the median console time was 76 min (range: 29-465 min). The cumulative sum (CUSUM) graph for total operation time indicated an initial decrease at case 41, generating 3 distinct performance phases: learning ( = 41 initial cases), competence ( = 54 middle cases), and mastery ( = 28 final cases). There was one case conversion to open surgery due to the difficulty in securing the field of view because of a 16-cm bulky mass protruding from the left pelvic wall. No patients required a transfusion and two complications including vaginal cuff dehiscence were identified. The single-site robot-assisted hysterectomy is a safe and feasible procedure. The learning curve consisted of 41 cases to significantly decrease the total operation time.