Crossover-effects in technical skills between laparoscopy and robot-assisted surgery

Hardon, Sem F.; Willuth, E; Rahimi, A Masie; Lang, Franziska; Haney, Caelán Max; Felińska, Eleni Amelia; Kowalewski, Karl‐Friedrich; Müller‐Stich, Beat P.; Peet, Donald L. van der; Daams, Freek; Nickel, Felix; Horeman, Tim

doi:10.1007/s00464-023-10045-6

Cited by 4 publications

(2 citation statements)

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“…Instrument Rotation Management: Given the robotic instruments’ enhanced flexibility, allowing for 540 degrees of rotation compared to the human wrist’s 360 degrees, it is important to frequently reset tools, particularly the ultrasonic scalpel, to their initial position (marked at 270 degrees). This practice ensures harmony between the surgeon’s hand movements and the robotic instruments ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Optimizing robotic thyroid surgery: lessons learned from an retrospective analysis of 104 cases

Wang,

Yu,

et al. 2024

Front. Endocrinol.

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BackgroundRobotic assistance in thyroidectomy is a developing field that promises enhanced surgical precision and improved patient outcomes. This study investigates the impact of the da Vinci Surgical System on operative efficiency, learning curve, and postoperative outcomes in thyroid surgery.MethodsWe conducted a retrospective cohort study of 104 patients who underwent robotic thyroidectomy between March 2018 and January 2022. We evaluated the learning curve using the Cumulative Sum (CUSUM) analysis and analyzed operative times, complication rates, and postoperative recovery metrics.ResultsThe cohort had a mean age of 36 years, predominantly female (68.3%). The average body mass index (BMI) was within the normal range. A significant reduction in operative times was observed as the series progressed, with no permanent hypoparathyroidism or recurrent laryngeal nerve injuries reported. The learning curve plateaued after the 37th case. Postoperative recovery was consistent, with no significant difference in hospital stay duration. Complications were minimal, with a noted decrease in transient vocal cord palsy as experience with the robotic system increased.ConclusionRobotic thyroidectomy using the da Vinci system has demonstrated a significant improvement in operative efficiency without compromising safety. The learning curve is steep but manageable, and once overcome, it leads to improved surgical outcomes and high patient satisfaction. Further research with larger datasets and longer follow-up is necessary to establish the long-term benefits of robotic thyroidectomy.

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Section: Discussionmentioning

confidence: 99%

Optimizing robotic thyroid surgery: lessons learned from an retrospective analysis of 104 cases

Wang,

Yu,

et al. 2024

Front. Endocrinol.

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“…There is always an important trade-off between the device’s capabilities and the time the surgeons need to learn and operate. The level of training and support offered is important to optimize the surgeon’s learning curve [ 4 – 6 ]. The surgical platforms may have different purchase and operating costs.…”

Section: Methodsmentioning

confidence: 99%

Review of robotic surgery platforms and end effectors

Cepolina,

Razzoli

2024

J Robotic Surg

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In the last 50 years, the number of companies producing automated devices for surgical operations has grown extensively. The population started to be more confident about the technology capabilities. The first patents related to surgical robotics are expiring and this knowledge is becoming a common base for the development of future surgical robotics. The review describes some of the most popular companies manufacturing surgical robots. The list of the company does not pretend to be exhaustive but wishes to give an overview of the sector. Due to space constraints, only a limited selction of companies is reported. Most of the companies described are born in America or Europe. Advantages and limitations of each product firm are described. A special focus is given to the end effectors; their shape and dexterity are crucial for the positive outcome of the surgical operations. New robots are developed every year, and existing robots are allowed to perform a wider range of procedures. Robotic technologies improve the abilities of surgeons in the domains of urology, gynecology, neurology, spine surgery, orthopedic reconstruction (knee, shoulder), hair restoration, oral surgery, thoracic surgery, laparoscopic surgery, and endoscopy.

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Crossover-effects in technical skills between laparoscopy and robot-assisted surgery

et al. 2023

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Introduction Robot-assisted surgery is often performed by experienced laparoscopic surgeons. However, this technique requires a different set of technical skills and surgeons are expected to alternate between these approaches. The aim of this study is to investigate the crossover effects when switching between laparoscopic and robot-assisted surgery. Methods An international multicentre crossover study was conducted. Trainees with distinctly different levels of experience were divided into three groups (novice, intermediate, expert). Each trainee performed six trials of a standardized suturing task using a laparoscopic box trainer and six trials using the da Vinci surgical robot. Both systems were equipped with the ForceSense system, measuring five force-based parameters for objective assessment of tissue handling skills. Statistical comparison was done between the sixth and seventh trial to identify transition effects. Unexpected changes in parameter outcomes after the seventh trial were further investigated. Results A total of 720 trials, performed by 60 participants, were analysed. The expert group increased their tissue handling forces with 46% (maximum impulse 11.5 N/s to 16.8 N/s, p = 0.05), when switching from robot-assisted surgery to laparoscopy. When switching from laparoscopy to robot-assisted surgery, intermediates and experts significantly decreased in motion efficiency (time (sec), resp. 68 vs. 100, p = 0.05, and 44 vs. 84, p = 0.05). Further investigation between the seventh and ninth trial showed that the intermediate group increased their force exertion with 78% (5.1 N vs. 9.1 N, p = 0.04), when switching to robot-assisted surgery. Conclusion The crossover effects in technical skills between laparoscopic and robot-assisted surgery are highly depended on the prior experience with laparoscopic surgery. Where experts can alternate between approaches without impairment of technical skills, novices and intermediates should be aware of decay in efficiency of movement and tissue handling skills that could impact patient safety. Therefore, additional simulation training is advised to prevent from undesired events.

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Crossover-effects in technical skills between laparoscopy and robot-assisted surgery

Cited by 4 publications

References 55 publications

Optimizing robotic thyroid surgery: lessons learned from an retrospective analysis of 104 cases

Optimizing robotic thyroid surgery: lessons learned from an retrospective analysis of 104 cases

Review of robotic surgery platforms and end effectors

Crossover-effects in technical skills between laparoscopy and robot-assisted surgery

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