Learning Curve of Multiport Robotic Cholecystectomy: A Cumulative Sum Analysis.

Abstract

To establish the learning curve of multiport robotic cholecystectomy (MRC). A retrospective analysis of patients undergoing MRC was performed. A cumulative sum analysis helped define the learning curve through the evaluation of skin-to-skin (STS) time and postoperative complications rate. Direct comparison of variables was conducted between the phases. Two hundred forty-five MRC cases were included. Average STS and console times were 50.6 and 29.9 minutes, respectively. Cumulative sum analysis established 3 phases with inflection points at cases 84th and 134th. A significant decrease in STS time was observed between the phases. Middle and late phases encompassed patients with higher comorbidities. Two conversions to open were recorded in the early phase. Postoperative complication rates were comparable among the early (2.5%), middle (6.8%), and late (5.6%) phases (P = 0.482). A steady decrease in STS time was observed across the 3 different phases established at the 84th and 134th patients.