1. Robotic Colorectal Cancer Surgery. How to Reach Expertise? A Single Surgeon-Experience
- Author
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Nicola D’Alesio, Michele Manigrasso, Alessandra Marello, Marco Milone, Sara Vertaldi, Salvatore Aprea, Pietro Anoldo, Giovanni Domenico De Palma, Antonio Vitiello, Alessia Chini, Carmen Sorrentino, Mario Musella, A. D'Amore, Salvatore D’Angelo, Manigrasso, M., Vertaldi, S., Anoldo, P., D'Amore, A., Marello, A., Sorrentino, C., Chini, A., Aprea, S., D'Angelo, S., D'Alesio, N., Musella, M., Vitiello, A., De Palma, G. D., and Milone, M.
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robotic ,Laparoscopic surgery ,medicine.medical_specialty ,Colorectal cancer ,medicine.medical_treatment ,Medicine (miscellaneous) ,colorectal cancer ,Article ,laparoscopic ,03 medical and health sciences ,0302 clinical medicine ,Colorectal cancer surgery ,Medicine ,Prospective cohort study ,colorectal ,business.industry ,General surgery ,Cancer ,medicine.disease ,Colorectal surgery ,Single surgeon ,learning curve ,030220 oncology & carcinogenesis ,Operative time ,030211 gastroenterology & hepatology ,business - Abstract
The complexity associated with laparoscopic colorectal surgery requires several skills to overcome the technical difficulties related to this procedure. To overcome the technical challenges of laparoscopic surgery, a robotic approach has been introduced. Our study reports the surgical outcomes obtained by the transition from laparoscopic to robotic approach in colorectal cancer surgery to establish in which type of approach the proficiency is easier to reach. Data about the first consecutive 15 laparoscopic and the first 15 consecutive robotic cases are extracted, adopting as a comparator of proficiency the last 15 laparoscopic colorectal resections for cancer. The variables studied are operative time, number of harvested nodes, conversion rate, postoperative complications, recovery outcomes. Our analysis includes 15 patients per group. Our results show that operative time is significantly longer in the first 15 laparoscopic cases (p = 0.001). A significantly lower number of harvested nodes was retrieved in the first 15 laparoscopic cases (p = 0.003). Clavien Dindo I complication rate was higher in the first laparoscopic group, but without a significant difference among the three groups (p = 0.09). Our results show that the surgeon needed no apparent learning curve to reach their laparoscopic standards. However, further multicentric prospective studies are needed to confirm this conclusion.
- Published
- 2021
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