Domenech Asbun, MD, Ruby Skinner, MD, FACS, Andrea Pakula, MD, MPH, FACS. Kern Medical
INTRODUCTION: The use of robotic technology is rapidly increasing among general surgeons but is not being routinely taught in general surgery residency. We aimed to evaluate our first 100 robotic cases during which time we developed a robotic surgery curriculum incorporating residents.
METHODS: The first 100 robotic cases performed at our institution from 2016-2017 by two surgeons were analyzed. A residency curriculum was developed and instituted after the first 6 months. It consisted of online modules offered by Intuitive Surgical resulting in certification, simulator training, hands on workshops for cannula placement, docking, instrument exchange, camera clutching and other introductory tasks. Patient demographics, type of procedure, resident involvement, total operative and console times, comorbid conditions and complications were evaluated. Unpaired t tests were performed for statistical analysis.
RESULTS: 66 females and 34 males comprised this series with an average age of 44 years ±12. The majority of patients, 71% had comorbidities, with a predominance of hypertension, 59% and diabetes, 37%. The bariatric patients had an average BMI of 48±10.
A variety of procedures were performed including hernias, foregut and bariatric. Residents participated in 40% of cases. There were no differences in total operative and console times in cases with residents except bariatric procedures. There were 3 complications in this series; postoperative ileus, gallbladder fossa hematoma and an enterotomy. There was one early conversion to open in a complex foregut case and no deaths in this series.
CONCLUSIONS: We report our initial experience of robotics in a variety of general surgery and complex foregut cases. The implementation of a robotic surgery program and residency curriculum was safe with similar outcomes related to operative times and complications. As MIS expands with the application of robotics in general surgery, residency curriculums will need to be revised. Further data is needed to determine residency learning curves between robotics and laparoscopy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87173
Program Number: P773
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster