title: Analysis of robotic performance times to improve operative efficiency.
abstract: OBJECTIVE
  To estimate the efficiency of procedural steps in robotic sacrocolpopexy and concomitant hysterectomy.
  
  
  METHODS
  Retrospective study (Canadian Task Force classification II-2).
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred forty-seven patients who underwent robotic-assisted procedures from November 2007 through December 2010.
  
  
  METHODS
  Robotic-assisted sacrocolpopexy. Sixty patients (40.8%) underwent concomitant hysterectomy; 37 (25.2%), mid-urethral sling placement; and 7 (4.8%), concomitant colporrhaphy.
  
  
  RESULTS
  Comparison of the first 20 procedures with the subsequent 127 demonstrated that there was considerable improvement in time of cuff closure (p = .04); sacral dissection (p = .004); anterior (p = .006), posterior, (p = .003), and sacral (p = .003) mesh attachment; peritoneal closure (p < .001); total docked time (p = .02); and total incision time (p < .001).
  
  
  CONCLUSIONS
  Robotic efficiency improves over a short learning period, with greatest differences in intracorporeal suturing and overall times. Identifying these steps may aid surgeons and learners in improving overall efficiency and establishing benchmarks for performance.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Pelvic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7570, USA. egeller@med.unc.edu
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Geller
authors.forename: Feng-Chang
authors.initials: FC
authors.lastname: Lin
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Matthews
mesh_terms: D002170:Canada; D004526:Efficiency; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D059032:Learning Curve; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D013526:Surgical Mesh; D013647:Task Performance and Analysis; D013997:Time Factors