Yıldırım Beyazıt University, Faculty of Medicine, Department of General Surgery - Ankara, Turkey.
Ataturk Research and Training Hospital, Department of General Surgery - Ankara, Turkey.
Rev Assoc Med Bras (1992). 2021 Jul;67(7):1033-1037. doi: 10.1590/1806-9282.20210526.
This study was designed to compare the standard and robotic-assisted laparoscopic donor nephrectomy in terms of perioperative course, short-term postoperative outcome, and to evaluate the effect of surgeon's learning curve on these parameters.
This was a prospective randomized study including 60 patients (mean age, 47 years; age, 21-72 years; 26 males, 34 females) who had been planned laparoscopic donor nephrectomies in our clinic. For comparison of standard and robot-assisted techniques and to evaluate the impact of learning curve, patients were randomized into three groups by a computer, each group containing 20 patients. Group 1: standard laparoscopic donor nephrectomies; Group 2: the first 20 patients who underwent robot-assisted laparoscopic donor nephrectomy; and Group 3: the next 20 patients who underwent robot-assisted laparoscopic donor nephrectomy.
Operative time was significantly higher in Group 2 (221.0±45.1 min) than both Group 1 (183.5±16.9 min, p=0.001) and Group 3 (186.5±20.6 min, p=0.002). Similarly, time for laparoscopic system setup was significantly higher in Group 2 (39.5±8.6 min), which contained the first cases of robot-assisted laparoscopic donor nephrectomy where surgeon had least experience than Group 1 (19.3±3.7 min, p<0.001) and Group 3 (24.0±9.4 min, p<0.001). On the other hand, duration of operation and time for laparoscopic system setup was similar between Groups 1 and 3.
Learning curve extends the operative time and laparoscopic system setup time in robotic-assisted laparoscopic donor nephrectomy, however, after the learning process was completed, these parameters were similar between robotic-assisted and standard laparoscopic nephrectomy.
本研究旨在比较标准腹腔镜供肾切取术与机器人辅助腹腔镜供肾切取术的围手术期过程、短期术后结果，并评估术者学习曲线对这些参数的影响。
这是一项前瞻性随机研究，纳入了 60 例（平均年龄 47 岁；年龄 21-72 岁；男 26 例，女 34 例）在我院计划行腹腔镜供肾切取术的患者。为了比较标准技术和机器人辅助技术，并评估学习曲线的影响，我们通过计算机将患者随机分为三组，每组 20 例。组 1：标准腹腔镜供肾切取术；组 2：前 20 例接受机器人辅助腹腔镜供肾切取术的患者；组 3：接下来 20 例接受机器人辅助腹腔镜供肾切取术的患者。
组 2 的手术时间明显长于组 1（221.0±45.1 min）和组 3（186.5±20.6 min，p=0.001）。同样，腹腔镜系统设置时间在组 2（39.5±8.6 min）中明显更高，该组包含了机器人辅助腹腔镜供肾切取术的前几例，术者在此阶段经验最少，明显长于组 1（19.3±3.7 min，p<0.001）和组 3（24.0±9.4 min，p<0.001）。另一方面，组 1 和组 3 之间的手术时间和腹腔镜系统设置时间相似。
学习曲线延长了机器人辅助腹腔镜供肾切取术的手术时间和腹腔镜系统设置时间，但在学习过程完成后，这些参数在机器人辅助腹腔镜和标准腹腔镜肾切取术之间相似。
