Learning Curve of Robotic Lobectomy for the Treatment of Lung Cancer: How Does It Impact on the Autonomic Nervous System of the Surgeon?
Objective: Our purpose is to define the learning curve for robot-assisted thoracoscopic surgery lobectomy by reporting the experience of a single surgeon. Material and methods: We progressively collected the data concerning the surgical performance of a single male thoracic surgeon, from the beginni...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-01-01
|
| Series: | Journal of Personalized Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4426/13/2/193 |
| _version_ | 1797619985483300864 |
|---|---|
| author | Antonio Mazzella Shehab Mohamed Patrick Maisonneuve Giulia Sedda Andrea Cara Monica Casiraghi Francesco Petrella Stefano Maria Donghi Giorgio Lo Iacono Lorenzo Spaggiari |
| author_facet | Antonio Mazzella Shehab Mohamed Patrick Maisonneuve Giulia Sedda Andrea Cara Monica Casiraghi Francesco Petrella Stefano Maria Donghi Giorgio Lo Iacono Lorenzo Spaggiari |
| author_sort | Antonio Mazzella |
| collection | DOAJ |
| description | Objective: Our purpose is to define the learning curve for robot-assisted thoracoscopic surgery lobectomy by reporting the experience of a single surgeon. Material and methods: We progressively collected the data concerning the surgical performance of a single male thoracic surgeon, from the beginning of his robotic activity as first operator from January 2021 to June 2022. We evaluated several pre-, intra- and postoperative parameters concerning patients and intraoperative cardiovascular and respiratory outcomes of the surgeon, recorded during surgical interventions, in order to evaluate his cardiovascular stress. We used cumulative sum control charts (CUSUM) to analyze the learning curve. Results: A total of 72 lung lobectomies were performed by a single surgeon in this period. Analyzing the CUSUM of several parameters, the inflection point identifying the transition beyond the surgeon learning phase was reached at cases 28, 22, 27 and 33 when considering operating time, mean heart rate, max heart rate and mean respiratory rate, respectively. Conclusions: The learning curve for robotic lobectomy seems to be safe and feasible with a correct robotic training program. The analysis of a single surgeon from the beginning of his robotic activity demonstrates that confidence, competence, dexterity and security are achieved after about 20–30 procedures, without compromising efficiency and oncological radicality. |
| first_indexed | 2024-03-11T08:34:45Z |
| format | Article |
| id | doaj.art-949e923253424c26884a78a05886b7a9 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-11T08:34:45Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-949e923253424c26884a78a05886b7a92023-11-16T21:32:01ZengMDPI AGJournal of Personalized Medicine2075-44262023-01-0113219310.3390/jpm13020193Learning Curve of Robotic Lobectomy for the Treatment of Lung Cancer: How Does It Impact on the Autonomic Nervous System of the Surgeon?Antonio Mazzella0Shehab Mohamed1Patrick Maisonneuve2Giulia Sedda3Andrea Cara4Monica Casiraghi5Francesco Petrella6Stefano Maria Donghi7Giorgio Lo Iacono8Lorenzo Spaggiari9Division of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, ItalyDivision of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, ItalyDivision of Epidemiology and Biostatistics, IEO, European Institute of Oncology IRCCS, 20141 Milan, ItalyDivision of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, ItalyDivision of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, ItalyDivision of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, ItalyDivision of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, ItalyDivision of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, ItalyDivision of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, ItalyDivision of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, ItalyObjective: Our purpose is to define the learning curve for robot-assisted thoracoscopic surgery lobectomy by reporting the experience of a single surgeon. Material and methods: We progressively collected the data concerning the surgical performance of a single male thoracic surgeon, from the beginning of his robotic activity as first operator from January 2021 to June 2022. We evaluated several pre-, intra- and postoperative parameters concerning patients and intraoperative cardiovascular and respiratory outcomes of the surgeon, recorded during surgical interventions, in order to evaluate his cardiovascular stress. We used cumulative sum control charts (CUSUM) to analyze the learning curve. Results: A total of 72 lung lobectomies were performed by a single surgeon in this period. Analyzing the CUSUM of several parameters, the inflection point identifying the transition beyond the surgeon learning phase was reached at cases 28, 22, 27 and 33 when considering operating time, mean heart rate, max heart rate and mean respiratory rate, respectively. Conclusions: The learning curve for robotic lobectomy seems to be safe and feasible with a correct robotic training program. The analysis of a single surgeon from the beginning of his robotic activity demonstrates that confidence, competence, dexterity and security are achieved after about 20–30 procedures, without compromising efficiency and oncological radicality.https://www.mdpi.com/2075-4426/13/2/193learning curvelobectomyrobotic surgeryrobotic-assisted surgeryRATSsurgical stress |
| spellingShingle | Antonio Mazzella Shehab Mohamed Patrick Maisonneuve Giulia Sedda Andrea Cara Monica Casiraghi Francesco Petrella Stefano Maria Donghi Giorgio Lo Iacono Lorenzo Spaggiari Learning Curve of Robotic Lobectomy for the Treatment of Lung Cancer: How Does It Impact on the Autonomic Nervous System of the Surgeon? Journal of Personalized Medicine learning curve lobectomy robotic surgery robotic-assisted surgery RATS surgical stress |
| title | Learning Curve of Robotic Lobectomy for the Treatment of Lung Cancer: How Does It Impact on the Autonomic Nervous System of the Surgeon? |
| title_full | Learning Curve of Robotic Lobectomy for the Treatment of Lung Cancer: How Does It Impact on the Autonomic Nervous System of the Surgeon? |
| title_fullStr | Learning Curve of Robotic Lobectomy for the Treatment of Lung Cancer: How Does It Impact on the Autonomic Nervous System of the Surgeon? |
| title_full_unstemmed | Learning Curve of Robotic Lobectomy for the Treatment of Lung Cancer: How Does It Impact on the Autonomic Nervous System of the Surgeon? |
| title_short | Learning Curve of Robotic Lobectomy for the Treatment of Lung Cancer: How Does It Impact on the Autonomic Nervous System of the Surgeon? |
| title_sort | learning curve of robotic lobectomy for the treatment of lung cancer how does it impact on the autonomic nervous system of the surgeon |
| topic | learning curve lobectomy robotic surgery robotic-assisted surgery RATS surgical stress |
| url | https://www.mdpi.com/2075-4426/13/2/193 |
| work_keys_str_mv | AT antoniomazzella learningcurveofroboticlobectomyforthetreatmentoflungcancerhowdoesitimpactontheautonomicnervoussystemofthesurgeon AT shehabmohamed learningcurveofroboticlobectomyforthetreatmentoflungcancerhowdoesitimpactontheautonomicnervoussystemofthesurgeon AT patrickmaisonneuve learningcurveofroboticlobectomyforthetreatmentoflungcancerhowdoesitimpactontheautonomicnervoussystemofthesurgeon AT giuliasedda learningcurveofroboticlobectomyforthetreatmentoflungcancerhowdoesitimpactontheautonomicnervoussystemofthesurgeon AT andreacara learningcurveofroboticlobectomyforthetreatmentoflungcancerhowdoesitimpactontheautonomicnervoussystemofthesurgeon AT monicacasiraghi learningcurveofroboticlobectomyforthetreatmentoflungcancerhowdoesitimpactontheautonomicnervoussystemofthesurgeon AT francescopetrella learningcurveofroboticlobectomyforthetreatmentoflungcancerhowdoesitimpactontheautonomicnervoussystemofthesurgeon AT stefanomariadonghi learningcurveofroboticlobectomyforthetreatmentoflungcancerhowdoesitimpactontheautonomicnervoussystemofthesurgeon AT giorgioloiacono learningcurveofroboticlobectomyforthetreatmentoflungcancerhowdoesitimpactontheautonomicnervoussystemofthesurgeon AT lorenzospaggiari learningcurveofroboticlobectomyforthetreatmentoflungcancerhowdoesitimpactontheautonomicnervoussystemofthesurgeon |