Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug;17(4):1809-1816.
doi: 10.1007/s11701-023-01590-2. Epub 2023 Apr 21.

Characteristics of the learning curve in robotic thoracic surgery in an emerging country

Bruna Brandão de Rezende  1   2 , Lia Roque Assumpção  3 , Rui Haddad  4 , Ricardo Mingarini Terra  5   6 , Ruy Garcia Marques  3
Affiliations

Characteristics of the learning curve in robotic thoracic surgery in an emerging country

Bruna Brandão de Rezende et al. J Robot Surg. 2023 Aug.

Abstract

It is not established which factors impact the learning curve (LC) in robotic thoracic surgery (RTS), especially in emerging countries. The aim of this study is to analyze LC in RTS in Brazil and identify factors that can accelerate LC. We selected the first cases of two Brazilian surgeons who started their LC. We used CUSUM and the Lowess technique to measure LC for each surgeon and Poisson regression to assess factors associated with shorter console time (CT). 58 patients were operated by each surgeon and included in the analysis. Surgeries performed were different: Surgeon I (SI) performed 54 lobectomies (93.11%), whereas Surgeon II (SII) had a varied mix of cases. SI was proctored in his first 10 cases (17.24%), while SII in his first 41 cases (70.68%). The mean interval between surgeries was 8 days for SI and 16 days for SII. There were differences in the LC phases of the two surgeons, mainly regarding complications and conversions. There was shorter CT by 30% in the presence of a proctor, and by 20% with the Da Vinci Xi. Mix of cases did not seem to contribute to faster LC. Higher frequency between surgeries seems to be associated with a faster curve. Presence of proctor and use of bolder technologies reduced console time. We wonder if in phase 3 it is necessary to keep a proctor on complex cases to avoid serious complications. More studies are necessary to understand which factors impact the LC.

Keywords: Learning curve; Learning curve in robotic surgery; Robotic surgery; Thoracic robotic surgery; Thoracic surgery.

PubMed Disclaimer

References

    1. Terra RM, Araujo PHXN, Lauricella LL et al (2022) A Brazilian randomized study: robotic assisted vs. Video-assisted lung lobectomy outcomes (BRAVO trial). J Bras Pneumol 48(4):e20210464 - DOI - PubMed - PMC
    1. Kent MS, Hartwig MG, Vallières E et al (2021) Pulmonary open, robotic and Thoracoscopic Lobectomy (PORTaL) study: an analysis of 5,721 cases. Ann Surg. https://doi.org/10.1097/SLA.0000000000005115 - DOI - PubMed
    1. Jin R, Zheng Y, Yuan Y et al (2022) Robotic-assisted versus video-assisted Thoracoscopic Lobectomy: short-term results of a randomized clinical trial (RVlob Trial). Ann Surg 275(2):295–302. https://doi.org/10.1097/SLA.0000000000004922 - DOI - PubMed
    1. Bokhari MB, Patel CB, Ramos-Valadez DI, Ragupathi M, Haas EM (2011) Learning curve for robotic-assisted laparoscopic colorectal surgery. Surg Endosc 25(3):855–860. https://doi.org/10.1007/s00464-010-1281-x - DOI - PubMed
    1. Power AD, D’souza DM, Mofatt-Bruce SD, Merritt RE, Kneuertz PJ (2019) Defining the learning curve of robotic thoracic surgery: what does it take? Surg Endosc 33(12):3880–3888. https://doi.org/10.1007/s00464-019-07035-y - DOI - PubMed

LinkOut - more resources