Kozo Yoshikawa, Mitsuo Shimada, Jun Higashijima, Takuya Tokunaga, Masaaki Nishi, Hideya Kashihara, Chie Takasu, Toshiaki Yoshimoto. University of Tokushima
Background/Aims: The purpose of this study is to examine the usefulness of the step-wise training system for introducing robotic assisted gastrectomy.
Step-wise training system: Our step-wise training consists of 5 parts (basic training, advanced training, clinical experience, self-assessment and feedback and brash-up in wet lab). This system is based on PDCA cycle of training. 1st step is training by simulator, 2nd step is training by a wet training using pigs and ultra-realistic practice models, 3rd step is checking the operation time in individual section in operation. 4th step is self-assessment and feedback by all member of our department. The last step is re-training in wet lab using pigs after recognition of the problems.
Method: Initially robotic gastrectomy was performed without step-wise training(Group 1)(n=7 TG:2, DG:5)(Dec/2011-Oct/2012), Now robotic gastrectomy was performed with step-wise training(Group 2)(n=10 TG:1, DG:9)(May/2018-), and recent consecutive laparoscopic distal gastrectomy patients was examined (Group 3) (n=30). We examine the operation time and intraoperative bleeding and incidence of all surgical morbidities.
Result: Operative time was significantly shorter in group 2 than group 1 (377min vs 517min, p=0.01). But group 1 took a significantly longer time compared to group 3 (377min vs 270min, p=0.01). When we focused on patients after technically stable in group 2 (n=6), there was no significant difference compared with group 3(318min vs 270min, p=0.08). In intra-operative bleeding, there was significant difference between group 1 and group 2(137ml vs 15min, p=0.01). On the other hand, there was no significant difference between group 2 and group 3(15ml vs 18min, p=0.6). There was no surgical morbidity (>grade 3 CD criteria) in all three groups.
Conclusion: Robotic surgery was successfully introduced and safely performed, furthermore, our step-wise training system is useful to perform the robotic surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94030
Program Number: P666
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster
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