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单部位机器人胆囊切除术:社区教学医院中临床结果及与外科医生经验相关的学习曲线比较

Single-site robotic cholecystectomy: comparison of clinical outcome and the learning curves in relation to surgeon experience in a community teaching hospital.

作者信息

Dughayli Mohamad, Shimunov Sergey, Johnson Sherry, Baidoun Fadi

机构信息

Department of General Surgery, Henry Ford Wyandotte Hospital, 2333 Biddle Avenue, Wyandotte, MI, 48192, USA.

出版信息

BMC Surg. 2018 Jun 11;18(1):39. doi: 10.1186/s12893-018-0373-8.

Abstract

BACKGROUND

The aim of this study was to analyze the experience of two surgeons who have different laparoscopic skills and case volume, with single-site robotic cholecystectomy (SSRC) and evaluate their learning curves.

METHODS

All SSRCs performed between March 2013 and April 2015 were retrospectively reviewed. The patients were divided among two surgeons based on the surgeon's level of laparoscopic skills and case volume. Surgeon 1 had experience in advanced laparoscopy while surgeon 2 had basic laparoscopic skills. Patients' demographic data, intraoperative and short-term postoperative results were assessed.

RESULTS

The analysis included 102 patients for surgeon 1 and 15 patients for surgeon 2. There were no major or minor complications in either cohort. Operative time was significantly longer for surgeon 2, conversion to laparoscopy rate was 4% for surgeon 1 compared to 20% for surgeon 2, P = 0.044, which is statistically significant.

CONCLUSIONS

SSRC is an easy and safe procedure that can be quickly learned and performed in a reproducible manner by surgeons with experienced laparoscopic skills and greater case volume.

摘要

背景

本研究的目的是分析两位腹腔镜技术和手术量不同的外科医生进行单孔机器人胆囊切除术(SSRC)的经验,并评估他们的学习曲线。

方法

回顾性分析2013年3月至2015年4月期间进行的所有SSRC手术。根据外科医生的腹腔镜技术水平和手术量将患者分配给两位外科医生。外科医生1有高级腹腔镜手术经验,而外科医生2只有基本的腹腔镜技术。评估患者的人口统计学数据、术中及术后短期结果。

结果

分析包括外科医生1的102例患者和外科医生2的15例患者。两个队列均未出现重大或轻微并发症。外科医生2的手术时间明显更长,外科医生1的腹腔镜中转率为4%,而外科医生2为20%,P = 0.044,具有统计学意义。

结论

SSRC是一种简单安全的手术,有经验的腹腔镜技术和较多手术量的外科医生可以快速学习并以可重复的方式进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00e3/5996517/324aa05200fb/12893_2018_373_Fig1_HTML.jpg

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