Comparing the learning curve for robotically assisted and straight stick laparoscopic procedures in surgical novices.
BACKGROUND
Robotically assisted laparoscopic surgery has a different learning curve to straight stick laparoscopic surgery. The learning curve for novices is likely to be different to that for experienced surgeons. We assessed the early learning curve for trainees with 18 months or less of surgical experience.


METHODS
Six surgical novices performed 120 exercises using laparoscopic instruments and a DaVinci S robot. The exercise comprised cutting out a computer-generated paper circle. Time to completion, number of instrument changes and accuracy were compared (Kruskal-Wallis test).


RESULTS
Trainees required significantly less time using the robot (326 vs. 433 s; p < 0.0001); recorded fewer mistakes (1 vs. 4.5; p < 0.0001) and fewer instrument changes (1 vs. 3; p < 0.0001). Significant improvement was demonstrated in time, number of mistakes and instrument changes for robotically-assisted laparoscopic surgery.


CONCLUSIONS
For surgical novices tested on an in vitro dexterity exercise, a robotically assisted laparoscopic system offers a shorter learning curve and improved accuracy compared to straight stick surgery.
Royal Marsden Hospital, London, UK. dr.tina.rashid@doctors.org.uk
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D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods* / Q000523:psychology; D007858:Learning; D059032:Learning Curve; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D013514:Surgical Procedures, Operative / Q000379:methods* / Q000523:psychology