Niccolò Ramacciotti, Francesco Celotto, Federico Pinto, Jessica Cassiani, Giacomo Danieli, Gaya Spolverato, Luca Morelli, Francesco Maria Bianco
{"title":"达芬奇单端口机器人系统胆囊切除术的学习曲线。","authors":"Niccolò Ramacciotti, Francesco Celotto, Federico Pinto, Jessica Cassiani, Giacomo Danieli, Gaya Spolverato, Luca Morelli, Francesco Maria Bianco","doi":"10.1097/SLE.0000000000001394","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgery is recognized as the gold standard for cholecystectomy, with various approaches having been implemented over time. Since 2018, the da Vinci Single-Port (DVSP) robotic system (Intuitive) has been used in experimental surgical contexts, revitalizing interest in single-site surgical techniques. The authors' aim is to describe the learning curve associated with single-port robotic cholecystectomy (SPRC).</p><p><strong>Methods: </strong>A prospective series of 266 consecutive off-label SPRC performed by a single surgeon experienced in laparoscopy, single-site surgery, and multiport robotic surgery was analyzed. These procedures were conducted under an Institutional Review Board-approved protocol. Preoperative, intraoperative, and postoperative data were collected and organized. Indications for SPRC included symptomatic cholelithiasis, acute cholecystitis, chronic cholecystitis, porcelain gallbladder, gallbladder polyps, choledocholithiasis, and gallstone pancreatitis. A learning curve was generated using the cumulative sum analysis (CUSUM) to assess changes in overall operation time, docking time, pre-console time, and surgeon console time.</p><p><strong>Results: </strong>Our analysis demonstrated a statistically significant reduction in docking time and pre-console time (P<0.001) in the 3 phases identified by the CUSUM analysis. The CUSUM analysis identified only 1 phase regarding the console time with a mean time of 20 (7 to 113) minutes. The average overall time was 59 (19 to 175) minutes. CUSUM analysis identified 3 phases for overall time, with reduction from 59 to 46 minutes (P<0.001). The general characteristics of the groups identified for OT were homogeneous. Analysis of early surgical outcomes did not differ between the groups.</p><p><strong>Conclusions: </strong>SPRC is a safe and feasible procedure, the docking time, pre-console time, and overall time were improving over time, meanwhile the console time was stable throughout the case series demonstrating a significant ability transfer between other mininvasive approaches and DVSP Platform.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Learning Curve for da Vinci Single-Port Robotic System Cholecystectomy.\",\"authors\":\"Niccolò Ramacciotti, Francesco Celotto, Federico Pinto, Jessica Cassiani, Giacomo Danieli, Gaya Spolverato, Luca Morelli, Francesco Maria Bianco\",\"doi\":\"10.1097/SLE.0000000000001394\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Minimally invasive surgery is recognized as the gold standard for cholecystectomy, with various approaches having been implemented over time. Since 2018, the da Vinci Single-Port (DVSP) robotic system (Intuitive) has been used in experimental surgical contexts, revitalizing interest in single-site surgical techniques. The authors' aim is to describe the learning curve associated with single-port robotic cholecystectomy (SPRC).</p><p><strong>Methods: </strong>A prospective series of 266 consecutive off-label SPRC performed by a single surgeon experienced in laparoscopy, single-site surgery, and multiport robotic surgery was analyzed. These procedures were conducted under an Institutional Review Board-approved protocol. Preoperative, intraoperative, and postoperative data were collected and organized. Indications for SPRC included symptomatic cholelithiasis, acute cholecystitis, chronic cholecystitis, porcelain gallbladder, gallbladder polyps, choledocholithiasis, and gallstone pancreatitis. A learning curve was generated using the cumulative sum analysis (CUSUM) to assess changes in overall operation time, docking time, pre-console time, and surgeon console time.</p><p><strong>Results: </strong>Our analysis demonstrated a statistically significant reduction in docking time and pre-console time (P<0.001) in the 3 phases identified by the CUSUM analysis. The CUSUM analysis identified only 1 phase regarding the console time with a mean time of 20 (7 to 113) minutes. The average overall time was 59 (19 to 175) minutes. CUSUM analysis identified 3 phases for overall time, with reduction from 59 to 46 minutes (P<0.001). The general characteristics of the groups identified for OT were homogeneous. Analysis of early surgical outcomes did not differ between the groups.</p><p><strong>Conclusions: </strong>SPRC is a safe and feasible procedure, the docking time, pre-console time, and overall time were improving over time, meanwhile the console time was stable throughout the case series demonstrating a significant ability transfer between other mininvasive approaches and DVSP Platform.</p>\",\"PeriodicalId\":22092,\"journal\":{\"name\":\"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-07-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/SLE.0000000000001394\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/SLE.0000000000001394","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Learning Curve for da Vinci Single-Port Robotic System Cholecystectomy.
Background: Minimally invasive surgery is recognized as the gold standard for cholecystectomy, with various approaches having been implemented over time. Since 2018, the da Vinci Single-Port (DVSP) robotic system (Intuitive) has been used in experimental surgical contexts, revitalizing interest in single-site surgical techniques. The authors' aim is to describe the learning curve associated with single-port robotic cholecystectomy (SPRC).
Methods: A prospective series of 266 consecutive off-label SPRC performed by a single surgeon experienced in laparoscopy, single-site surgery, and multiport robotic surgery was analyzed. These procedures were conducted under an Institutional Review Board-approved protocol. Preoperative, intraoperative, and postoperative data were collected and organized. Indications for SPRC included symptomatic cholelithiasis, acute cholecystitis, chronic cholecystitis, porcelain gallbladder, gallbladder polyps, choledocholithiasis, and gallstone pancreatitis. A learning curve was generated using the cumulative sum analysis (CUSUM) to assess changes in overall operation time, docking time, pre-console time, and surgeon console time.
Results: Our analysis demonstrated a statistically significant reduction in docking time and pre-console time (P<0.001) in the 3 phases identified by the CUSUM analysis. The CUSUM analysis identified only 1 phase regarding the console time with a mean time of 20 (7 to 113) minutes. The average overall time was 59 (19 to 175) minutes. CUSUM analysis identified 3 phases for overall time, with reduction from 59 to 46 minutes (P<0.001). The general characteristics of the groups identified for OT were homogeneous. Analysis of early surgical outcomes did not differ between the groups.
Conclusions: SPRC is a safe and feasible procedure, the docking time, pre-console time, and overall time were improving over time, meanwhile the console time was stable throughout the case series demonstrating a significant ability transfer between other mininvasive approaches and DVSP Platform.
期刊介绍:
Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.