OGBN P26 Institutional initial experience and outcomes for the first 100 Upper gastrointestinal Cases: A single tertiary center results

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Abstract Background Robotic surgery is widely spreading in many centers across the United Kingdom. Potential benefits include shorter admissions, fewer complications as well as better surgeon ergonomics and dexterity. Evidence suggests that robotic surgery has a rapid learning curve when first implemented with the number of cases linked to operative time. In this study, we report our preliminary results after implementation of robotic surgery at our upper gastrointestinal unit. Methods This retrospective study included all robotic elective upper gastrointestinal cases since the introduction of robotic surgery at our unit. All cases were performed by two surgeons using Da Vinci XI starting in August 2022. The first 100 cases were completed in 10 months. Both surgeons completed Intuitive training prior to initiating their independent operating lists. Cholecystectomy and anti-reflux surgeries were the main surgeries performed during the study period. Demographics, number of cases per list, console timing and postoperative complications were collected and analysed. Console timing was obtained by Intuitive software. Postoperative complications were graded using the Clavien-Dindo scale. Results 100 UGI robotic surgery cases were analysed consisting of 86 cholecystectomies and 14 anti-reflux operations. Females represented the majority of cases (68%). Mean age was 53.0 years (18-78) while mean ASA and BMI were 2 and 30.3 kg/m2 respectively. Mean console time was 53.3 minutes. Cholecystectomies required 43.0 minutes and anti-reflux surgeries required 119.3 minutes on average. The mean length of stay was 0.90 days for cholecystectomies, and 1.46 days for anti-reflux surgery. There were two readmissions post cholecystectomy for pneumonia and liver bed collection. One cholecystectomy patient developed a Clavien-Dindo grade >3 complication for port site hernia repair. Conclusions Our initial experience has shown favourable outcomes of robotic surgery. There was a noticeable rapid learning curve, encountering only one major post-operative complication. This high effectiveness should stimulate the swift introduction of robotic surgery to other hospitals.