Learning curves in robotic surgery: A retrospective analysis

Abstract

Abstract Purpose: The purpose of this study was to outline the surgical outcomes associated with learning curves before and after achieving proficiency in the first 150 robot-assisted hysterectomies in an individual surgeon. Methods: We retrospectively analyzed the outcomes of patients who underwent robotic hysterectomy between February 2021 and August 2023. All perioperative details of each procedure were meticulously recorded by qualified personnel using standardized case report forms. The collected data included various parameters, namely, age, body mass index (BMI), obstetric and medical histories, and operative characteristics. Results: The mean patient age at the time of surgery was 49.8 years, and the mean BMI was 28.5. The mean total operative time was 98.6 min, the mean total docking time (DT) was 13.3 min, and the mean console time (CT) was 33.5 min. The mean estimated blood loss was 66.1 mL and the mean specimen weight was 281.1 g. Most patients were discharged 2.62 days after surgery. The analysis of patients by the learning curve showed that the operation, DT, and CT were significantly longer in patients treated before the surgeon achieved proficiency versus those treated after. Conclusion: Robot-assisted hysterectomies performed in the later phases of the surgeon’s learning curve showed significant decreases in operative, DT, and CT. Surgical proficiency, as measured by operative time, was attained in 50–60 cases.