Experience matters for robotic assistance: an analysis of case data

Abstract

Many robotic procedures require active participation by assistants. Most prior work on assistants’ effect on outcomes has been limited in procedural focus and scope, with studies reporting differing results. Knowing how assistant experience affects operating room time could inform operating room case scheduling and provide an impetus for additional assistant training. As such, this retrospective cohort study aimed to determine the association between assistant experience and operating room time for 2291 robotic-assisted operations performed from 2016 to 2022 at our institution. Linear regression showed a significant association between the presence of a junior resident and increased case length differential with an increase of 26.9 min (p = 0.01). There were no significant associations between the presence of a senior resident (p = 0.52), presence of a fellow (p = 0.20), or presence of a physician assistant (p = 0.43) and case length differential. The finding of increased operating room time in the presence of a junior resident during robotic cases supports consideration of the adoption of formal assistant training programs for residents to improve efficiency.

Robotic-assisted laparoscopic radical hysterectomy for early-stage cervical cancer: The more experienced the bedside assistant, the better?

“…In this study, we found that BA with less than five years of experience did indeed lengthen the average operative time by approximately 29 min in line with a large retrospective study of 2,219 surgeries including prostatectomy, hysterectomy, and inguinal hernia repair, which showed that inexperienced BA prolonged operative time around 26.9 min [ 31 ]. However, in terms of postoperative complication, positive resection margin, intraoperative organ damage, lymph node dissection count, and hospital stays, we did not find any detrimental effects in the inexperienced BA 1 group or in learning phase of the learning curve.…”