Introduction/Background The transition from an established laparoscopic practice to the new robotic era is challenging for the surgeons and the service. Our aim is to evaluate the learning curve of a pioneer laparoscopic surgeon through the development of a new robotic service using Da Vinci-XI-system (DaVinci-XI; Intuitive Surgical Ltd) in Gynaecological Oncology, focused on patients’ safety outcomes.
Methodology All robotic cases (n=27) performed in the Northern Gynaecological Oncology Centre (NGOC), QE Hospital, Gateshead have been identified from departmental database. Clinico-pathological data, learning curve time-based metrics but also clinical metrics including peri-operative morbidity, surgical outcomes and length of stay were extrapolated from patients’ electronic database. Patients were divided into two groups: the early experience (n = 13) and a late experience group (n = 14) and the outcomes were compared. All procedures were performed by a single Gynaecological Oncologist, pioneer in laparoscopic surgery.
Results 27 robotic surgeries have been performed in the NGOC from the beginning of the robotic program in Gynaecological Oncology, 63% of these for malignancy. 10 (37%) had a robotic nodal excision and the detection rate for sentinel nodes was 89%. There was no return to theatre or conversion to laparotomy/laparoscopy in this cohort of patients. 1 (3.7%) intra-op complication identified (bowel serosa injury) and repaired. 6 (22%) patient had Clavien-Dindo grade 2 post-op complications needing pharmacological intervention and 1 patient re-admitted for IV antibiotics for wound infection. Blood loss was minimal in both early and late experience group [37.5 (10–250) vs 50mls (20–250), p 0.414] and there was no statistical difference regarding the length of stay [median 1day (1–3)] and the peri-operative complications.
Conclusion Robotic surgery, even in the early experience period has excellent results regarding patients’ safety, Oncologic outcomes, including overall survival and progression free survival cannot be evaluated in such a short period of time.
Disclosures Authors have no conflict of interest to declare
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