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Surgical training in robotic surgery: surgical experience of robotic-assisted transabdominal preperitoneal inguinal herniorrhaphy with and without resident participation

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Abstract

Robotic-assisted surgery is becoming more popular in general surgery. Implementation of a robotic curriculum is necessary and will influence surgical training. The aim of this study is to compare surgical experience and outcomes with and without resident participation in robotic inguinal herniorrhaphy. A retrospective review of patients who underwent either unilateral or bilateral robotic-assisted transabdominal preperitoneal (TAPP) inguinal herniorrhaphy, with and without resident participation as console surgeons from January through December 2015, was performed. Patient demographics, procedure-related data, postoperative variables, and follow-up data were analyzed. A total of 104 patients were included. Patients were significantly older in the Resident group (57.5 ± 14.1 vs 50.6 ± 13.5 years, p = 0.01). Gender, BMI, and ASA classification were similar between groups. There were similar mean operative times for unilateral (89.9 ± 19.5 vs 84.8 ± 22.2 min, p = 0.42) and bilateral (128.4 ± 21.9 vs 129.8 ± 50.9 min, p = 0.90) inguinal herniorrhaphy as well as mean robot console times for unilateral (73.2 ± 18.4 vs 67.3 ± 29.9 min, p = 0.44) and bilateral (115.5 ± 24.6 vs 109.3 ± 55.4 min, p = 0.67) inguinal herniorrhaphy with and without resident participation, respectively. Postoperative complications included urinary retention (11.1 vs 2.0%, p = 0.11), conversion to open repair (0 vs 2%, p = 0.48), and delayed reoperation (0 vs 4%, p = 0.22) with and without resident participation, respectively. Patients’ symptoms/signs at follow-up were similar among groups. Robotic-assisted TAPP inguinal herniorrhaphy with resident participation as console surgeons did not affect the hospital operative experience or patient outcomes. This procedure can be implemented as part of the resident robotic curriculum with rates of morbidity equivalent to those of published studies.

Level of evidence 2b.

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Abbreviations

TAPP:

Transabdominal preperitoneal

BMI:

Body mass index

ASA:

American Society of Anesthesiologists

SD:

Standard deviation

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA

    Jessica Gonzalez-Hernandez

  2. Department of Surgery, Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX, 75246, USA

    Lam D. Le

  3. Baylor Scott and White Health, 8080 North Central Expressway, Suite 500, Dallas, TX, USA

    Purvi Prajapati & Gerald Ogola

  4. Department of Surgery, Baylor Scott and White Medical Center, 5252 W University Dr, McKinney, TX, USA

    Ryan D. Burkart & Lam D. Le

Authors
  1. Jessica Gonzalez-Hernandez
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  2. Purvi Prajapati
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  3. Gerald Ogola
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  4. Ryan D. Burkart
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  5. Lam D. Le
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Corresponding author

Correspondence to Jessica Gonzalez-Hernandez.

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Conflict of interest

Jessica Gonzalez-Hernandez, MD, declares that she has no conflict of interest. Purvi Prajapati, BS, declares that she has no conflict of interest. Gerald Ogola, PhD, declares that he has no conflict of interest. Ryan D Burkart, MD, declares that he has no conflict of interest. Lam D Le, MD, declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors. This article is a retrospective study of medical charts and this article does not contain any results of direct human interactions by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was not required per the Institutional Review Board since this was a retrospective review of medical charts.

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Gonzalez-Hernandez, J., Prajapati, P., Ogola, G. et al. Surgical training in robotic surgery: surgical experience of robotic-assisted transabdominal preperitoneal inguinal herniorrhaphy with and without resident participation. J Robotic Surg 12, 487–492 (2018). https://doi.org/10.1007/s11701-017-0771-4

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  • DOI: https://doi.org/10.1007/s11701-017-0771-4

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