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. 2021 Dec;35(12):6796-6806.
doi: 10.1007/s00464-020-08184-1. Epub 2020 Dec 7.

Short-term clinical outcomes of a European training programme for robotic colorectal surgery

Sofoklis Panteleimonitis  1 , Danilo Miskovic  2 , Rachelle Bissett-Amess  3 , Nuno Figueiredo  3 , Matthias Turina  4 , Giuseppe Spinoglio  5 , Richard J Heald  3   6 , Amjad Parvaiz  7   8   9 ; EARCS Collaborative
Affiliations

Short-term clinical outcomes of a European training programme for robotic colorectal surgery

Sofoklis Panteleimonitis et al. Surg Endosc. 2021 Dec.

Abstract

Background: Despite there being a considerable amount of published studies on robotic colorectal surgery (RCS) over the last few years, there is a lack of evidence regarding RCS training pathways. This study examines the short-term clinical outcomes of an international RCS training programme (the European Academy of Robotic Colorectal Surgery-EARCS).

Methods: Consecutive cases from 26 European colorectal units who conducted RCS between 2014 and 2018 were included in this study. The baseline characteristics and short-term outcomes of cases performed by EARCS delegates during training were analysed and compared with cases performed by EARCS graduates and proctors.

Results: Data from 1130 RCS procedures were collected and classified into three cohort groups (323 training, 626 graduates and 181 proctors). The training cases conversion rate was 2.2% and R1 resection rate was 1.5%. The three groups were similar in terms of baseline characteristics with the exception of malignant cases and rectal resections performed. With the exception of operative time, blood loss and hospital stay (training vs. graduate vs. proctor: operative time 302, 265, 255 min, p < 0.001; blood loss 50, 50, 30 ml, p < 0.001; hospital stay 7, 6, 6 days, p = 0.003), all remaining short-term outcomes (conversion, 30-day reoperation, 30-day readmission, 30-day mortality, clinical anastomotic leak, complications, R1 resection and lymph node yield) were comparable between the three groups.

Conclusions: Colorectal surgeons learning how to perform RCS under the EARCS-structured training pathway can safely achieve short-term clinical outcomes comparable to their trainers and overcome the learning process in a way that minimises patient harm.

Keywords: Minimally invasive colorectal surgery; Robotic colorectal surgery; Robotic rectal surgery; Robotic surgery training; Surgical training.

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Conflict of interest statement

The infrastructure for central coordination of the European Academy of Robotic Colorectal Surgery (EARCS) is hosted by the Champalimaud Foundation (Avenida Brasilia, Lisbon, Portugal) with the previous support of Intuitive Surgical Sàrl (Chemin des Mûriers, 1, CH 1170 Aubonne, Switzerland). However, EARCS is a standalone project and central coordination is hosted at the Champalimaud Foundation, Avenida da Brasilia, 1400–038 Lisbon, Portugal. Some of the surgeons who participated in the study are proctors for Intuitive Surgical Sàrl. However, no surgeon was paid to participate in the study carried out as part of this paper. Sofoklis Panteleimonitis, Nuno Figueiredo, Rachelle Bissett-Amess, Matthias Turina and Richard J. Heald have no conflicts of interest or financial ties to disclose. Danilo Miskovic, Giuseppe Spinoglio and Amjad Parvaiz are proctors for Intuitive Surgical Sàrl.

Figures

Fig.1
Fig.1
CUSUM conversion
Fig. 2
Fig. 2
CUSUM CD 3–5
See this image and copyright information in PMC

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