A community hospital’s experience with robotic thoracic surgery

Karnik, Nihaal; Yang, Xihua; Goussous, Naeem; Howe, Lindsay S; Karras, Riny

doi:10.1007/s12055-019-00848-5

Cited by 2 publications

(4 citation statements)

References 16 publications

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“…A total of 209 studies on the learning curve of robotic lobectomies were identified in the literature search, with twenty-two progressing to inclusion. The studies included in this review were overwhelmingly retrospective ( 9 - 28 ) versus prospective ( 29 , 30 ) in nature. The majority of studies (twelve) were drawn from North America, with the remainder from Europe (three), China (three), Japan (two) Korea (one) and the Middle East (one).…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies (twelve) were drawn from North America, with the remainder from Europe (three), China (three), Japan (two) Korea (one) and the Middle East (one). Upon quality assessment, twelve studies were deemed to be of high quality ( 9 , 13 , 15 - 17 , 19 - 22 , 25 , 26 , 29 ), nine of medium quality ( 10 , 11 , 14 , 18 , 23 , 24 , 27 , 28 , 30 ) and one of low quality ( 12 ). Risk of bias assessment illustrated low-risk in the majority of studies, with only four demonstrating minor concerns ( 11 , 23 , 28 , 30 ) (see Figure S2 ).…”

Section: Resultsmentioning

confidence: 99%

“…However, stratifying for single versus multi-surgeon outcomes would too heavily restrict case volumes so as to render aggregation inappropriate. Complexity of pathology was not homogenized across consecutive cases, which is reflected in a bimodal distribution and/or plateauing of operating time in several studies ( 20 , 28 ). The overwhelming majority of the studies included were also retrospective in nature, with the inherent risks of biases entailed in such a study design.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of studies (twelve) were drawn from North America, with the remainder from Europe (three), China (three), Japan (two) Korea (one) and the Middle East (one). Upon quality assessment, twelve studies were deemed to be of high quality (9,13,(15)(16)(17)(19)(20)(21)(22)25,26,29), nine of medium quality (10,11,14,18,23,24,27,28,30) and one of low quality (12). Risk of bias assessment illustrated low-risk in the majority of studies, with only four demonstrating minor concerns (11,23,28,30) (see Figure S2).…”

Section: Study Characteristicsmentioning

confidence: 99%

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The learning curve of the robotic-assisted lobectomy—a systematic review and meta-analysis

Wilson-Smith¹,

Anning²,

Muston³

et al. 2023

Ann Cardiothorac Surg

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Background Early studies have illustrated the robotic lobectomy to be safe, oncologically effective, and economically feasible as a therapeutic modality in the treatment of thoracic malignancies. The ‘challenging’ learning curve seemingly associated with the robotic approach, however, continues to be an often-cited factor to its ongoing uptake, with the overwhelming volume of these surgeries being performed in centers of excellence where extensive experience with minimal access surgery is the norm. An exact quantification of this learning curve challenge, however, has not been made, begging the question of whether this is an outdated assumption, versus fact. This systematic review and meta-analysis sort to clarify the learning curve for robotic-assisted lobectomy based on the existing literature. Methods An electronic search of four databases was performed to identify relevant studies outlining the learning curve of robotic lobectomy. The primary endpoint was a clear definition of operator learning (e.g., cumulative sum chart, linear regression, outcome-specific analysis, etc.) which could be subsequently aggregated or reported. Secondary endpoints of interest included post-operative outcomes and complication rates. A meta-analysis using a random effects model of proportions or means was applied, as appropriate. Results The search strategy identified twenty-two studies relevant for inclusion. A total of 3,246 patients (30% male) receiving robotic-assisted thoracic surgery (RATS) were identified. The mean age of the cohort was 65.3±5.0 years. Mean operative, console and dock time was 190.5±53.8, 125.8±33.9 and 10.2±4.0 minutes, respectively. Length of hospital stay was 6.1±4.6 days. Technical proficiency with the robotic-assisted lobectomy was achieved at a mean of 25.3±12.6 cases. Conclusions The robotic-assisted lobectomy has been illustrated to have a reasonable learning curve profile based on the existing literature. Current evidence on the oncologic efficacy and purported benefits of the robotic approach will be bolstered by the results of upcoming randomized trials, which will be critical in supporting RATS uptake.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The majority of studies (twelve) were drawn from North America, with the remainder from Europe (three), China (three), Japan (two) Korea (one) and the Middle East (one). Upon quality assessment, twelve studies were deemed to be of high quality (9,13,(15)(16)(17)(19)(20)(21)(22)25,26,29), nine of medium quality (10,11,14,18,23,24,27,28,30) and one of low quality (12). Risk of bias assessment illustrated low-risk in the majority of studies, with only four demonstrating minor concerns (11,23,28,30) (see Figure S2).…”

Section: Study Characteristicsmentioning

confidence: 99%

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