학술논문

Learning Curves in Establishing a New Minimally Invasive Pancreas Program.
Document Type
Article
Source
American Surgeon. Oct2023, Vol. 89 Issue 10, p4166-4170. 5p.
Subject
*PANCREAS
*PANCREATIC fistula
*PANCREATICODUODENECTOMY
*TRAINING of surgeons
*ONCOLOGIC surgery
*LEARNING
Language
ISSN
0003-1348
Abstract
Introduction: Robotic pancreaticoduodenectomy (rPD) is a complex operation with a reported learning curve of 80 cases. Two recent graduates of a formal robotic complex general surgical oncology training program have been performing rPD at our institution since 2016, which had no previous institutional experience with rPD. Objective: To evaluate the learning curve associated with developing a new robotic pancreaticoduodenectomy (rPD) program by fellowship trained surgeons with institutional support. Methods: Sixty patients undergoing rPD from 2016 to 2022 were reviewed for and compared with proficiency benchmarks set by the University of Pittsburg experience. Results: By 30 cases, operative time met the proficiency benchmark of 391 minutes. Additionally, the entire cohort had comparable rates of clinically relevant postoperative pancreatic fistula (6.7% vs 3%, P =.6), 30-day mortality (0% vs 3%, P =.18), major complications (Clavien >2; 23% vs 17%, P =.14), and length of stay (6 vs 7 days, P =.49) when compared to the benchmark. Conclusion: Perioperative outcomes were comparable to proficiency benchmarks from initiation of the new rPD program, and operative time reached proficiency benchmark by 30 cases. This data suggests that graduates of formal rPD training programs can safely establish new minimally invasive pancreas programs at sites with no previous institutional rPD experience. [ABSTRACT FROM AUTHOR]