Surgeons' Learning Curve of Renaissance Robotic Surgical System

Abstract

Introduction: A few articles on robot-assisted pedicle screw placement described the learning curve but failed to report on the overall operative time, including cases in which the robotic system malfunctioned. The purpose of this study was to identify a single surgeon's learning curve including estimated blood loss, surgery time, anesthesia time, robot time, and complications. Methods: A retrospective study was performed between January 2016 and August 2018 for patients who underwent posterior spinal fusion using the Mazor robot. Based on the charts, the robot time, time of anesthesia, and surgery time were recorded, as were the complications, misplacement of screws, and blood loss. Results: Of 62 robot-assisted surgeries scheduled, only 46 were performed (74.2%) upon patients with a mean age of 63.3 6 13.0 years. The mean follow-up time was 13.2 6 8.0 months and most commonly a fusion from L4 to S1 was performed (20/46, 43.5%). A high improvement in estimated intraoperative blood loss was observed of 755.7 6 344.7 mL (slope ¼ À9.89). A decrease in time in anesthesia, surgery, and robotic usage was identified with a slope factor of

Initial Intraoperative Experience with Robotic-Assisted Pedicle Screw Placement with Cirq® Robotic Alignment: An Evaluation of the First 70 Screws

“…A significant improvement in estimated intraoperative blood loss was observed with a decrease in time in anesthesia, surgery, and robotic usage as well as a decrease in pedicle screw-insertion time and operative time [13]. The complication rate did not show any learning curve [13]. Technical issues such as registration and installation issues, a software bug and a placement issue have been described [13].…”

“…Lonjon et al found a significantly longer mean operative time in the robotic cohort than the freehand cohort, and attributed this increased time to both the learning curve and set-uptime for robotic use [53]. A significant improvement in estimated intraoperative blood loss was observed with a decrease in time in anesthesia, surgery, and robotic usage as well as a decrease in pedicle screw-insertion time and operative time [13]. The complication rate did not show any learning curve [13].…”

“…Robot-assisted spine surgery, which can provide an efficient and accurate mode of hardware placement, is relatively new and still seldom used by spine surgeons [13]. As with any new surgical technology, there is a significant learning curve involved with the robotic system [13].…”

“…Robot-assisted spine surgery, which can provide an efficient and accurate mode of hardware placement, is relatively new and still seldom used by spine surgeons [13]. As with any new surgical technology, there is a significant learning curve involved with the robotic system [13]. This study presents our initial experience with thoracolumbar pedicle screw placement using the Brainlab's Cirq ® surgeon-controlled robotic arm (BrainLab, Munich, Germany).…”

Workflow and Efficiency of Robotic-Assisted Navigation in Spine Surgery

“…There was no difference in operative times between the initial adoption phase and later periods, which would imply a negligible learning curve at best [7]. Bäcker et al found that overall procedural times decreased as more robotic-assisted procedures were performed but also concluded that there was no major learning curve for the technology [2]. Interestingly, Urakov et al examined robotic surgeries and identified a trend toward improved efficiency with pedicle screw placement over time, although no statistically significant pattern was discovered [14].…”