title: Minimizing operative time for robotic gastrectomy in cancer: analysis of the major factors for four detailed steps.
abstract: OBJECTIVE
  We outlined the major factors for minimizing the operative time of robotic-assisted gastrectomy (RAG) during the initial learning period.
  
  
  METHODS
  We performed correlation analysis and multivariate linear regression for detailed operation steps including preparing, docking, console and anastomosis time.
  
  
  RESULTS
  Forty patients underwent RAG for cancer. By Pearson analysis, case number (r = -0.313; P = 0.049) and body mass index (BMI) (r = 0.368; P = 0.019) were found to be correlated with total operation time. Multivariate linear regression with backward elimination showed that BMI and case number significantly affected total operation time. A detailed four-step analysis showed that docking time was significantly affected by intraoperative complications.
  
  
  CONCLUSIONS
  In conclusion, we recommend a V-shape port placement as an important surgical factor for preparation and docking time to avoid unnecessary intraoperative trial errors. In addition, selecting lower-BMI patients would be helpful in shortening the time to mastery of console, which is the most time consuming operative step of the robotic procedure for robotic-naive surgeons.
authors.forename: Myung-Han
authors.initials: MH
authors.lastname: Hyun
authors.forename: Jin-Woo
authors.initials: JW
authors.lastname: Park
authors.forename: Doo-Sup
authors.initials: DS
authors.lastname: Shin
authors.forename: Jun-Min
authors.initials: JM
authors.lastname: Cho
authors.forename: Kyung-Sook
authors.initials: KS
authors.lastname: Yang
authors.forename: Sungsoo
authors.initials: S
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D065287:Robotic Surgical Procedures / Q000379:methods*; D013274:Stomach Neoplasms / Q000601:surgery*