title: Learning experience using the double-console da Vinci surgical system in gynecology: a prospective cohort study in a University hospital.
abstract: OBJECTIVE
  To report our preliminary experience with robotic-assisted laparoscopy in a variety of gynecological surgeries in a teaching hospital.
  
  
  METHODS
  A total of 33 patients who underwent robotic-assisted laparoscopic procedures for gynecological diseases were included in the study. All surgeries were performed using the double-console da Vinci surgical system. Patient's demographics, surgical procedures, operative time, perioperative complications, conversion rate, hospital stay and estimated blood loss were prospectively collected.
  
  
  RESULTS
  All procedures were completed robotically except three (9%): two cases were converted to laparotomy and one case was converted to vaginal surgery. The mean age was 47 ± 11 and mean BMI was 23 kg/m². Mean time taken for docking the robot was 22 min. Mean operative time was 152 min. Mean anesthesia time was 196 min. Mean hemoglobin drop was 2 g/dL. Four complications occurred: one transitory ischemic attack, one port-site hernia managed through trocar incision, one periumbilical hematoma managed conservatively and one vaginal cuff hematoma who required laparoscopy. The mean hospital stay was 4 days.
  
  
  CONCLUSIONS
  With the use of robotic technology, surgeons are able to offer minimally invasive surgery to a larger percentage of patients. Double console system seems a promising tool in surgical education, improving both resident training and participation in surgeries. A shorter adaption to robotics could be expected in teams with previous experience with standard laparoscopy, however, a stepwise start with simpler cases is the key to achieve a safe adaption to robotic surgery.
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS Fondazione-Policlinico San Matteo, University of Pavia, Pavia, Italy. francescamarengo80@gmail.com
authors.forename: Francesca
authors.initials: F
authors.lastname: Marengo
authors.forename: Demetrio
authors.initials: D
authors.lastname: Larraín
authors.forename: Luciana
authors.initials: L
authors.lastname: Babilonti
authors.forename: Arsenio
authors.initials: A
authors.lastname: Spinillo
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery*; D006406:Hematoma / Q000209:etiology; D006547:Hernia / Q000209:etiology; D006785:Hospitals, University; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects / Q000193:education*; D059032:Learning Curve; D007902:Length of Stay; D008875:Middle Aged; D011446:Prospective Studies; D012371:Robotics / Q000193:education*; D013997:Time Factors