title: Robotic cholecystectomy and resident education: the UC Davis experience.
abstract: BACKGROUND
  The popularity of robotic surgery highlights the need for strategies to integrate this technique into surgical education. We present 5 year data for robotic cholecystectomy (RC) as a model for training residents.
  
  
  METHODS
  Data were collected on all RC over 66 months. Duration for docking the robot (S2) and performing RC (S3), and surgical outcomes, were recorded. We used a linear mixed effects model to investigate learning curves.
  
  
  RESULTS
  Thirty-eight trainees performed 160 RCs, with most performing more than four. One case was aborted due to haemodynamic instability, and two were converted to open surgery due to adhesions. There were no technical complications. The duration of S2 (mean = 6.2 ± 3.6 min) decreased considerably (p = 0.027). Trainees also demonstrated decrease in duration of S3 (mean = 38.4 ± 15.4 min), indicating improvement in technique (p = 0.008).
  
  
  CONCLUSIONS
  RC is an effective model for teaching residents. Significant and reproducible improvement can be realized with low risk of adverse outcomes.
authors.affiliation: Department of Surgery, University of Tennessee School of Medicine, Chattanooga, TN, USA.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Nelson
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Gottlieb
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Müller
authors.forename: William
authors.initials: W
authors.lastname: Smith
authors.forename: Mohamed R
authors.initials: MR
authors.lastname: Ali
authors.forename: Tamas J
authors.initials: TJ
authors.lastname: Vidovszky
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D002763:Cholecystectomy / Q000009:adverse effects / Q000193:education* / Q000379:methods; D005260:Female; D006801:Humans; D007396:Internship and Residency; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D061646:Operative Time; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000193:education* / Q000379:methods; D055815:Young Adult
keywords: cholecystectomy; da Vinci; laparoscopy; learning curve; robotic surgery; surgical education