Learning curve for robotic-assisted rectal surgery by a single surgeon

DOI Web Site 参考文献11件
  • Umemoto Takahiro
    Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital
  • Kijima Kazuhiro
    Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital
  • Harada Yoshikuni
    Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital
  • Shibata Shiori
    Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital
  • Nakamura Akihiro
    Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital
  • Oyama Hideyuki
    Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital
  • Uchida Tsuneyuki
    Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital
  • Kigawa Gaku
    Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital
  • Matsuo Kenichi
    Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital
  • Tanaka Kuniya
    Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital

抄録

This study aimed to investigate problems and learning curves experienced by a single surgeon performing robotic-assisted rectal surgery （RRS） for the first time. Among 62 consecutive patients who underwent RRS between May 2021 and December 2022, 30 with high anterior resection （HAR） performed by a single surgeon qualified according to the endoscopic surgical skill qualification system were retrospectively reviewed. Operative feasibility and surgical outcomes were evaluated. The cumulative sum （CUSUM） was used to visualize the learning curve of the operation time. No cases were converted to open surgery. The operative time （median, range） was 313 （163-645） min, the amount of blood loss was 5 （5-550） ml, and postoperative complications occurred in 10 （16.1％） of all 62 patients. Among 30 patients with HAR, the surgeon console time for the 10 patients in the early period was 160 （78-271） min, and that in the later period was 118 （86-234） min for 20 （P＝0.03）. The differences in the duration of lymph node dissection and mesorectal transection were significant between the early and later periods （P＜0.01）. No difference in the frequency of postoperative complications was found. RRS is a minimally invasive and safe technique even for an inexperienced surgeon according to the rectal endoscopic educational system. To shorten the learning curve, mastery of the surgical procedure of lymph node dissection and mesorectal dissection is necessary.

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