SP6.04 The learning curve of complications with RAS Colorectal Surgery: the experience of a single-centre

Background and Aims Robotic assisted surgery (RAS) has transformed colorectal surgery in recent years. A reduction in operative time and complication rates has been evidenced in some of the literature, although few studies exist that focus on complications during the learning curve of contemporaneous training. The aim of this study is to evaluate a single site’s experience of complications during the introduction of RAS colorectal surgery. Methods Retrospective analysis of elective colorectal RAS patients over a 3.5 year period was performed. Extraction of the first 100 patients was performed to comprise the “early” cohort, versus the most recent 100 patients, the “later” cohort. Patient demographics and operative metrics were collected for comparison. Data was collected on post-operative outcomes. Complications were recorded and graded according to the Clavien-Dindo (CD) classification. Results Demographics were comparable between groups, with median ages of 64 and 61 for the early cohort and later cohorts respectively, and a median BMI of 28 and 28.4 respectively. A decrease of 100 minutes was observed in median duration of procedure. A small reduction was seen in overall complication rate, falling from 20% to 18%. However major complications (CD ≥3) fell from 9% to 5%. A 3% decrease was also observed in 30 day re-admission rates. Conclusion Overall an improvement has been observed; major complications halved from the later compared to the earlier group, with a fall in re-admission rates. However as experience improved, case complexity likely increased and this may have altered the trajectory of improvement in complication rates.