FTP4.7 A stitch in time; Surgeon learning curve in Robotic Assisted Colorectal Cancer Resection Operating Times

Abstract

Abstract Aims We began performing Robotic Assisted (RAS) colorectal cancer (CRC) resections in our hospital in 2022. In order to understand whether we could demonstrate a surgeon learning curve, we assessed for any difference in median length of operating time (OT) in RAS CRC resections from their implementation to present time. Method We performed a retrospective review of theatre logs for RAS CRC resections from 2nd May 2022 until 17th January 2023. We recorded ‘knife to skin’ and ‘close’ time for each case alongside resection type. We included the 4 highest volume resection types and identified the median OT for the first half of cases, from which we subtracted the median OT from the second half of cases performed. We then calculated median time difference between the sets. Results As table 1 demonstrates, the median OT decreased for all included RAS CRC resections (n=51) from the first data set to the second. The median time saved over all resection types was 26.5 minutes. Discussion In surgery, demonstrating a learning curve involves looking at a marker of progress (such as operating time) and assessing it against exposure to, for example, a new technique or instrument. RAS represents a unique opportunity for this. We were able to demonstrate an early surgeon learning curve with a decrease in median OT across our highest volume RAS CRC resections within 8 months of their implementation at our centre.