Robotic surgical training: cholecystectomy

Background: The main advantages of robotics in general surgery may be for advanced minimally invasive procedures.Unlike other specialties, formal fellowship training opportunities for robotic general surgery are few.As a result, most surgeons currently develop robotic skills in practice and robotic cholecystectomy represents the operation of choice for general surgeons to acquire clinical da Vinci experience.Methods: Before performing advanced robotic procedures, 2 surgeons completed the Intuitive Surgical da Vinci-Xi training course and agreed to work together on all procedures.We performed a retrospective review of our pilot series of robotic cholecystectomies and compared them with contemporaneous laparoscopic controls.The primary outcome was safety, and the Secondary outcome was learning curve.Results: There were 30 procedures in the robotic arm and 45 in the laparoscopic group.One complication (port-site hernia) occurred in the laparoscopic group, and only one robotic patient (surgical wound infection) experienced a complication.The mean time required to perform robotic cholecystectomy was significantly long than laparoscopic surgery (68v.37min, p<0.001) due to the docking of da Vinci system.The mean time to clear the operating room was significantly longer for robotic procedures (20v.12min, p=0.015). Conclusion:Our experience may suggest that robotic cholecystectomy is a way by which general surgeons may gain confidence in performing advanced robotic procedures and it confirms the reliability of this training course.