Development of a gynecological robotic surgery program with the Da Vinci system: Beginnings and consolidation

Aims

This study aimed to evaluate the operative time, hospital stay and complications in patients undergoing robotic gynaecological surgery before and after completing the surgical team's learning curve.

Methods

Observational retrospective study that included 185 patients who underwent Da Vinci robot-assisted gynaecological surgery from January 2013 to December 2021 at the Gynaecology and Obstetrics Department of the Rey Juan Carlos University Hospital (Spain). The sample was divided into two groups: those conducted before and after the completion of the established learning curve, set at 35 procedures per surgeon.

Results

During the study period, 185 patients underwent robot-assisted gynaecological surgery, 77 (41.6%) during period one and 108 (58.4%) during period two after. The median reduction in operative time was 43 min (95% CI 17–70) in period two compared to period one. The median length of hospital stay was two days (IQR = 2–3) and one day (IQR = 1–2) (p = 0.001) respectively. There were no statistically significant differences in transfusion rates, complications, and readmissions.

Conclusions

Completing the learning curve significantly reduced the operative time and hospital stay. While there were fewer complications during the second period, these differences were not statistically significant.