Robot Docking Time: Cumulative Summation Analysis of a Procedure-Independent Learning Curve in Pediatric Urology

J Laparoendosc Adv Surg Tech A. 2018 Sep;28(9):1139-1141. doi: 10.1089/lap.2017.0418. Epub 2018 Jun 13.

Abstract

Purpose: The learning curve is an important method of assessment of progression in the use of a new technique or device and, in the field of robotic surgery, is most commonly described for individual procedures, often concentrating on console time and outcomes. We contemplated whether a learning curve of the similar nature and duration was exhibited in the procedure-independent variable of docking time.

Materials and methods: The time from first incision to end of robot docking was found for a single surgeon's first 55 robotic cases, which encompassed a range of pediatric urological procedures. Raw and cumulative summation (CUSUM) data were found and plotted, with learning- and maintenance-phase times compared statistically.

Results: A classical learning curve of ∼30 cases was found with a statistically significant reduction in time between learning and maintenance phases.

Conclusions: A learning curve of similar nature and duration to procedure-specific analyses was found for docking time. The variability of port placement and robot positioning for multiple procedures further increases the significance of this result.

Keywords: CUSUM analysis; learning curve; robot docking time.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Learning Curve*
  • Male
  • Operative Time*
  • Pediatrics / education*
  • Prospective Studies
  • Robotic Surgical Procedures / education*
  • Robotic Surgical Procedures / methods
  • United Kingdom
  • Urologic Surgical Procedures / education*
  • Urologic Surgical Procedures / methods
  • Urology / education*