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Robotic-assisted surgery enhances the learning curve while maintaining quality outcomes in sleeve gastrectomy: a preliminary, multicenter study

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Abstract

Background

The frequency of robotic-assisted bariatric surgery has been on the rise. An increasing number of fellowship programs have adopted robotic surgery as part of the curriculum. Our aim was to compare technical efficiency of a surgeon during the first year of practice after completing an advanced minimally invasive fellowship with a mentor surgeon.

Methods

A systematic review of a prospectively maintained database was performed of consecutive patients undergoing robotic-assisted sleeve gastrectomy between 2015 and 2019 at a tertiary-care bariatric center (mentor group) and between 2018 and 2019 at a semi-academic community-based bariatric program (mentee 1 group) and 2019–2020 at a tertiary-care academic center (mentee 2 group).

Results

257 patients in the mentor group, 45 patients in the mentee 1 group, and 11 patients in the mentee 2 group were included. The mentee operative times during the first year in practice were significantly faster than the mentor’s times in the first three (mentee 1 group) and two (mentee 2 group) years (P < 0.05) but remained significantly longer than the mentor’s times in the last two (mentee 1 group) and one (mentee 2 group) years (P < 0.05). There was no significant difference in venothromboembolic events (P = 0.89) or readmission rates (P = 0.93). The mean length of stay was 1.8 ± 0.5 days, 1.3 ± 0.5 days, and 1.5 ± 0.5 days in the mentor, mentee 1, and mentee 2 groups, respectively (P < 0.0001). There were no reoperations, conversion to laparoscopy or open, no staple line leaks, strictures, or deaths in any group.

Conclusions

This is one of the first series to show that the robotic platform can safely be taught and may translate into outcomes consistent with surgeons with more experience while mitigating the learning curve as early as the first year in practice. Long-term follow-up of mentees will be necessary to assess the evolution of fellowship training and outcomes.

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Funding

This study was internally funded.

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Authors and Affiliations

  1. Department of Surgery, New York Presbyterian Hospital—Weill Cornell Medicine, 525 East 68th St., Box 294, New York, NY, 10065, USA

    Omar Bellorin, Mariana Vigiola-Cruz, Omar Al Hussein Alawamlh, Alfons Pomp, Gregory Dakin & Cheguevara Afaneh

  2. Department of Surgery, Washington University, St. Louis, USA

    Omar Bellorin & Francesca Dimou

  3. Department of Surgery, Valley Hospital, Valley Health System, Ridgewood, USA

    Rachel At

Authors
  1. Omar Bellorin
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  2. Mariana Vigiola-Cruz
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  3. Francesca Dimou
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  4. Rachel At
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  5. Omar Al Hussein Alawamlh
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  6. Alfons Pomp
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  7. Gregory Dakin
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  8. Cheguevara Afaneh
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Corresponding author

Correspondence to Cheguevara Afaneh.

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Disclosures

Drs Afaneh reports honoraria from Intuitive Surgical, outside the submitted work. Drs. Bellorin reports honoraria from WL Gore outside of the submitted work. Drs. Dimou, Vigiola-Cruz, Alt, Al Hussein, Pomp, & Dakin have no conflicts of interest or financial tides to disclose.

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Bellorin, O., Vigiola-Cruz, M., Dimou, F. et al. Robotic-assisted surgery enhances the learning curve while maintaining quality outcomes in sleeve gastrectomy: a preliminary, multicenter study. Surg Endosc 35, 1970–1975 (2021). https://doi.org/10.1007/s00464-020-08228-6

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  • DOI: https://doi.org/10.1007/s00464-020-08228-6

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