General Papers 10

Abstract

Background: Robotic-enhanced surgery has emerged as a solution to some of the drawbacks of traditional minimal access surgery. Master–slave telemanipulator systems have been extensively used in surgical interventions, but the learning curve in this technology has not been objectively assessed. Aims: Delineate the learning curve of surgeons for a robotic task in a complex bench model. Find if there is a quantifiable learning process in a short period of exposure to the Da Vinci system. Methods: Nine surgeons completed five synthetic small bowel anastomoses (Limbs and things, UK) using the Da Vinci robotic system (Intuitive Surgical, CA) in standardized conditions. All procedures were digitized and quality scored independently by three surgeons employing the objective structured assessment of technical skills (OSATS). Wilcoxon signed ranks tests were used to compare the first and last attempts. A P-value < 0.05 was considered significant. Cronbach's-alpha was used to measure interrater reliability. Results: A learning curve was constructed using time and OSATS score of every task. Both variables showed a rapid and progressive learning process. Mean times for the first and last attempt were 3507 s and 2287 s (P < 0.008) and mean OSATS scores were 17 and 24 (P < 0.012), respectively. A high interobserver reliability was found (α = 0.894). Conclusions: This study clearly shows a significant reduction in the time taken (34 per cent) and improvement in quality (29 per cent) between the first and fifth attempt in a bench model. Therefore, we conclude that Da Vinci system allows fast adaptation and short learning process regardless previous surgical experience.