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Title: The learning curve in robotic colorectal surgery compared with laparoscopic colorectal surgery: a systematic review.
Epworth Authors: Flynn, Julie
Larach, Jose
Warrier, Satish
Heriot, Alexander
Other Authors: Kong, Joseph
Waters, Peadar
Keywords: Colorectal Surgery
Robotic Surgery
Learning Curve
Surgical Training
Department of Surgery, Epworth Healthcare, Richmond, Vic, Australia.
General Surgery & Gastroenterology Clinical Institute
Issue Date: Nov-2021
Publisher: Wiley
Citation: Colorectal Dis . 2021 Nov;23(11):2806-2820
Abstract: Aim: The learning curve has implications for efficient surgical training. Robotic surgery is perceived to have a shorter learning curve than laparoscopy; however, detailed analysis is lacking. The aim of this work was to analyse studies comparing robotic and laparoscopic colorectal learning curves. Simulation studies comparing novices' learning curves were analysed in order to surmise applicability to colorectal surgery. Method: A systematic search of Medline, PubMed, Embase and the Cochrane Library identified colorectal papers (from 1 January 2000 to 3 March 2021) comparing robotic and laparoscopic learning curves where surgeons lacked laparoscopic colorectal experience. Simulation studies comparing learning curves were also included. The learning curve was defined as the period of ongoing improvement in speed and/or accuracy. Results: From 576 abstracts reviewed, three operative and 16 simulation studies were included. The robotic learning curve for right colectomy was significantly faster in one study (16 vs. 25 cases) and equal for anterior resection in two studies (44 vs. 41 cases and 55 vs. 55). One study showed fewer complications for robotic patients (14.6% vs. 0%, p = 0.013). Ten simulation studies reported faster times and eight recorded error rates favouring robotic surgery. Seven studies measured the learning curve. Four favoured laparoscopic surgery, but operating times were faster using the robotic platform. Conclusion: Operating times for robotic surgery may be faster than laparoscopy when surgeons are inexperienced with both platforms. This may be related to a superior baseline performance rather than a shorter learning curve. Whether a shorter learning curve on the laparoscopic platform will persist for long enough to enable skills to overtake robotic ability needs further investigation.
DOI: 10.1111/codi.15843
PubMed URL:
ISSN: 1463-1318
Journal Title: Colorectal Disease
Type: Journal Article
Affiliated Organisations: Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia.
University of Melbourne, Melbourne, Vic., Australia.
Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia.
Type of Clinical Study or Trial: Systematic Reviews
Appears in Collections:General Surgery and Gastroenterology

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