Learning Curve Analysis of Single-Site Robot-Assisted Hysterectomy

We aim to analyze the surgical outcomes and learning curve of single-site robot-assisted hysterectomy. This was a retrospective cohort study from a single academic medical center. A total of 123 patients who underwent single-site robotic surgery for gynecologic disease were enrolled. Gynecologic surgeries were performed by a single surgeon using single-site robot-assisted hysterectomy. The median age of enrolled patients was 49 years (range: 30-74 years). The median operation time was 131 min (range: 59-502 min) and the median docking time was 3 min (range: 1-10 min). In addition, the median console time was 76 min (range: 29-465 min). The cumulative sum (CUSUM) graph for total operation time indicated an initial decrease at case 41, generating 3 distinct performance phases: learning (n = 41 initial cases), competence (n = 54 middle cases), and mastery (n = 28 final cases). There was one case conversion to open surgery due to the difficulty in securing the field of view because of a 16-cm bulky mass protruding from the left pelvic wall. No patients required a transfusion and two complications including vaginal cuff dehiscence were identified. The single-site robot-assisted hysterectomy is a safe and feasible procedure. The learning curve consisted of 41 cases to significantly decrease the total operation time.

Automated summary

This study aimed to analyze the outcomes and learning curve of single-site robot-assisted hysterectomy. The results showed that the procedure was safe and feasible, with a learning curve of 41 cases.