title: Learning curve analysis of intracorporeal cuff suturing during robotic single-site total hysterectomy.
abstract: OBJECTIVE
  To analyze the learning curve of intracorporeal cuff suturing during robotic single-site total hysterectomy.
  
  
  METHODS
  Retrospective study (Canadian Task Force classification II-1).
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Twenty-four patients with benign indications for hysterectomy.
  
  
  METHODS
  Twenty-four patients who underwent robotic single-site total hysterectomy to treat benign indications were included in the study. Surgical procedures were performed by a single surgeon with extensive experience in laparoscopy, using the single-site platform of the da Vinci Surgical System. All vaginal cuffs were closed intracorporeally using semi-rigid single-site instruments.
  
  
  RESULTS
  An exponential learning curve technique was used to analyze the learning curve. The overall mean (SD) vaginal cuff closure time was 23.2 (7) minutes. Learning curve analysis revealed a decrease in vaginal closure time after 14 procedures.
  
  
  CONCLUSIONS
  An experienced robotic surgeon requires approximately 14 procedures to achieve proficiency in intracorporeal cuff suturing during robotic single-site total hysterectomy. Novel instruments that create perfect triangulation are needed to overcome the current challenges of suturing and to shorten operative time.
authors: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.
authors: Ali
authors: A
authors: Akdemir
authors: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.
authors: Burak
authors: B
authors: Zeybek
authors: Department of Actuarial Sciences, Yasar University, Izmir, Turkey.
authors: Banu
authors: B
authors: Ozgurel
authors: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.
authors: Mehmet Kemal
authors: MK
authors: Oztekin
authors: Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey. Electronic address: fatih.sendag@gmail.com.
authors: Fatih
authors: F
authors: Sendag
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000193:education* / Q000379:methods*; D010535:Laparoscopy / Q000193:education / Q000379:methods; D059032:Learning Curve; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D012371:Robotics / Q000193:education* / Q000379:methods; D013536:Suture Techniques / Q000193:education*; D016896:Treatment Outcome
keywords: Intracorporeal cuff suturing; Laparoendoscopic single-site surgery; Learning curve; Total hysterectomy; da Vinci Single-Site Platform