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Correlation between operative time and crowd-sourced skills assessment for robotic bariatric surgery

  • 2020 SAGES Oral
  • Published:
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Abstract

Introduction

Operative time has been traditionally used as a proxy for surgical skill and is commonly utilized to measure the learning curve, assuming that faster operations indicate a more skilled surgeon. The Global Evaluative Assessment of Robotic Skills (GEARS) rubric is a validated Likert scale for evaluating technical skill. We hypothesize that operative time will not correlate with the GEARS score.

Methods

Patients undergoing elective robotic sleeve gastrectomy at a single bariatric center of excellence hospital from January 2019 to March 2020 were captured in a prospectively maintained database. For step-specific scoring, videos were broken down into three steps: ligation of short gastric vessels, gastric transection, and oversewing the staple line. Overall and step-specific GEARS scores were assigned by crowd-sourced evaluators. Correlation between operative time and GEARS score was assessed with linear regression and calculation of the R2 statistic.

Results

Sixty-eight patients were included in the study, with a mean operative time of 112 ± 27.4 min. The mean GEARS score was 20.1 ± 0.81. Mean scores for the GEARS subcomponents were: bimanual dexterity 4.06 ± 0.17; depth perception 3.96 ± 0.24; efficiency 3.82 ± 0.19; force sensitivity 4.06 ± 0.20; robotic control 4.16 ± 0.21. Operative time and overall score showed no correlation (R2 = 0.0146, p = 0.326). Step-specific times and scores showed weak correlation for gastric transection (R2 = 0.0737, p = 0.028) and no correlation for ligation of short gastric vessels (R2 = 0.0262, p = 0.209) or oversewing the staple line (R2 = 0.0142, p = 0.344).

Conclusions

Operative time and crowd-sourced GEARS score were not correlated. Operative time and GEARS scores measure different performance characteristics, and future studies should consider using both a validated skills assessment tool and operative time for a more complete evaluation of skill.

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Funding

This work was supported by a grant from the Society of American Gastrointestinal and Endoscopic Surgeons.

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Authors and Affiliations

  1. Department of General Surgery, Lenox Hill Hospital, Northwell Health, 186 E 76th St, 1st Floor, New York, NY, 10075, USA

    Poppy Addison, Jermyn Addy, Julio Teixeira & Filippo Filicori

  2. C-SATS, Inc., Seattle, WA, USA

    Andrew Yoo

  3. Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA

    Jacqueline Duarte-Ramos

  4. Institute for Spine and Scoliosis, Lawrenceville, NJ, USA

    Samuel Dechario

  5. Northwell Health, Manhasset, NY, USA

    Gregg Husk, Mark Jarrett & Anthony Antonacci

  6. Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA

    Julio Teixeira & Filippo Filicori

Authors
  1. Poppy Addison
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  2. Andrew Yoo
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  3. Jacqueline Duarte-Ramos
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  4. Jermyn Addy
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  5. Samuel Dechario
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  6. Gregg Husk
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  7. Mark Jarrett
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  8. Julio Teixeira
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  9. Anthony Antonacci
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  10. Filippo Filicori
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Corresponding author

Correspondence to Poppy Addison.

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Disclosures

Dr. Yoo is a full-time employee for C-SATS, Inc, a subsidiary of Johnson and Johnson. Dr. Teixeira is on the clinical advisory board for C-SATS, Inc. Dr. Filicori is a consultant for Cambridge Medical Robotics. Mr. Dechario, Drs. Addison, Duarte-Ramos, Addy, Husk, Jarrett, and Antonacci have no conflicts of interest or financial ties to disclose..

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Addison, P., Yoo, A., Duarte-Ramos, J. et al. Correlation between operative time and crowd-sourced skills assessment for robotic bariatric surgery. Surg Endosc 35, 5303–5309 (2021). https://doi.org/10.1007/s00464-020-08019-z

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  • DOI: https://doi.org/10.1007/s00464-020-08019-z

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