R. I. Ayabe1, A. Parrish1, C. Dauphine1,2, D. M. Hari1,2, J. Ozao-Choy1,2 1Harbor UCLA Medical Center,Department Of Surgery,Torrance, CA, USA 2David Geffen School Of Medicine At UCLA,Los Angeles, CA, USA
Introduction: Single-site robotic cholecystectomy (SSRC) using the da Vinci Si Surgical System™ achieves a superior cosmetic outcome with a nearly scarless single umbilical incision. We previously showed that SSRC is a safe procedure to introduce in a public teaching hospital after appropriate faculty and resident training. Here we sought to determine the most appropriate level of residency training at which to introduce SSRC.
Methods: 98 patients underwent elective SSRC with a general surgical resident as the primary console surgeon between August 2015 and August 2016. Patients were divided into two groups based on the resident’s level of training: second and third years (junior residents) vs fourth and fifth years (senior residents). Data on age, gender, race, BMI, comorbidities, total operative time, conversion to laparoscopic or open surgery, and complications were examined. The Student’s t-test and X2 test were used to analyze continuous and categorical data, respectively.
Results: Junior residents performed 54 SSRC cases, while senior residents performed 44 cases. There were no significant differences in age, gender, race, BMI, or comorbidities between the two groups. There was no significant difference in mean operative time between junior and senior residents (92.7 min for junior residents vs 98.0 min for senior residents, p = 0.254) There were no intraoperative complications in the junior resident group and one intraoperative complication, an enterotomy during abdominal entry, in the senior resident group. Overall, there was no significant difference in complication rate between the two groups (3.7% for junior residents vs 2.3% for senior residents, p = 0.68). There were no conversions to laparoscopic or open cholecystectomy.
Conclusion: As robotic surgery becomes more common across multiple surgical disciplines, it has become increasingly important to expose residents to this technology early in their training. SSRC provides a valuable opportunity to introduce surgical residents to robotic surgery. This data suggests that it is safe and feasible to begin training residents in SSRC as early as the second year of residency.