Structured training curricula for robotic colorectal surgery in China: does laparoscopic experience affect training effects?

Duohuo Shu; Zhenghao Cai; Xiang Yin; Minhua Zheng; Jianwen Li; Xiao Yang; Sen Zhang; Batuer Aikemu; Wei Qin; Ximo Xu; Yugui Lian; Jianping Zhou; Changqing Jing; Bo Feng

doi:10.21037/jgo-22-1193

Structured training curricula for robotic colorectal surgery in China: does laparoscopic experience affect training effects?

J Gastrointest Oncol. 2023 Feb 28;14(1):198-205. doi: 10.21037/jgo-22-1193.

Authors

Duohuo Shu^#¹, Zhenghao Cai^#¹, Xiang Yin^#², Minhua Zheng¹, Jianwen Li¹, Xiao Yang¹, Sen Zhang¹, Batuer Aikemu¹, Wei Qin¹, Ximo Xu¹, Yugui Lian³, Jianping Zhou⁴, Changqing Jing⁵, Bo Feng¹

Affiliations

¹ Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Department of Minimally Invasive Tumor Surgery, Daqing Oilfield General Hospital, Daqing, China.
³ Department of Colorectal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
⁴ Department of Gastrointestinal Surgery & Hernia and Abdominal Wall Surgery, The First Hospital, China Medical University, Shenyang, China.
⁵ Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

^# Contributed equally.

Abstract

Background: Robotic surgery has been widely adopted for colorectal cancer (CRC). Many surgeons in China have completed structured training programs and have performed robotic colorectal surgeries. This multicenter study aimed to evaluate the training effects of structured training curricula in China for surgeons with different laparoscopic experiences during their initial implementation of robotic colorectal surgery.

Methods: Ten surgeons from five high-volume centers participated in this retrospective study. The baseline characteristics, perioperative data, and pathological outcomes were compared between the first 15 robotic surgeries performed by five surgeons with extensive laparoscopic experience (group A) and the first 15 robotic surgeries performed by five surgeons with limited laparoscopic experience (group B) at each center.

Results: Compared with group B, group A showed shorter operation time (200.9 vs. 254.2 min, P<0.001), less blood loss (100.0 vs. 150.0 mL, P=0.025), and a lower incidence of intraoperative complications (2.7% vs. 21.4%, P=0.015). The reoperation rate (1.3% vs. 5.3%, P=0.036) and postoperative complication rate (6.7% vs. 22.7%, P=0.025) were significantly lower in group A than in group B. There were no statistically significant differences in baseline characteristics (e.g., age, sex, and tumor location) and pathological information (e.g., tumor stage, lymph node count, and tumor size) between the two groups. Radical resection (R0) was performed in all cases.

Conclusions: In China, structured training curricula can help surgeons with extensive laparoscopic experience make a smooth transition from laparoscopic to robotic surgery. However, the higher intraoperative and postoperative complication rates indicate that structured training curricula still require further refinement for surgeons with limited laparoscopic experience.

Keywords: Short-term outcomes; colorectal tumors; robotic colorectal surgery; structured training curricula.