Ashraf Junaid, Krishnan Jamie, Turner Alexander, Subramaniam Ramnath
Department of Paediatric Urology, Leeds General Infirmary , Leeds, United Kingdom .
J Laparoendosc Adv Surg Tech A. 2018 Sep;28(9):1139-1141. doi: 10.1089/lap.2017.0418. Epub 2018 Jun 13.
The learning curve is an important method of assessment of progression in the use of a new technique or device and, in the field of robotic surgery, is most commonly described for individual procedures, often concentrating on console time and outcomes. We contemplated whether a learning curve of the similar nature and duration was exhibited in the procedure-independent variable of docking time.
The time from first incision to end of robot docking was found for a single surgeon's first 55 robotic cases, which encompassed a range of pediatric urological procedures. Raw and cumulative summation (CUSUM) data were found and plotted, with learning- and maintenance-phase times compared statistically.
A classical learning curve of ∼30 cases was found with a statistically significant reduction in time between learning and maintenance phases.
A learning curve of similar nature and duration to procedure-specific analyses was found for docking time. The variability of port placement and robot positioning for multiple procedures further increases the significance of this result.
学习曲线是评估新技术或设备使用进展的重要方法，在机器人手术领域，通常针对单个手术进行描述，常常侧重于控制台操作时间和手术结果。我们思考在与手术无关的对接时间变量中是否呈现出性质和时长相似的学习曲线。
记录了一位外科医生的前55例机器人手术病例从首次切口到机器人对接结束的时间，这些病例涵盖了一系列小儿泌尿外科手术。获取并绘制了原始数据和累积求和（CUSUM）数据，对学习阶段和维持阶段的时间进行了统计学比较。
发现了一条约30例的经典学习曲线，学习阶段和维持阶段之间的时间有统计学意义的减少。
对接时间呈现出与特定手术分析性质和时长相似的学习曲线。多种手术中端口放置和机器人定位的可变性进一步增强了这一结果的重要性。
