title: Robotic anatomic lung resections: the initial experience and description of learning in 102 cases.
abstract: BACKGROUND
  The aim of this study was to analyze our initial pulmonary resection experience with robotic surgery (Da Vinci, Intuitive Surgical, Inc., Mountain View, California, USA) and define the learning curve based on the duration of operations.
  
  
  METHODS
  A retrospective review was conducted on patients undergoing robotic pulmonary resections from October 2011 to December 2014. The operating time, including the docking and console times, postoperative hospitalization, and peri- and postoperative complications were studied.
  
  
  RESULTS
  Hundred patients underwent 102 robotic anatomic pulmonary resections due to various pathologies. Fifty-three percent of the patients underwent lobectomy procedure, whereas 45% underwent segmentectomy. The mean operating time was 104 ± 34 min. The learning curve was calculated to be 14 patients (R(2) = 0.57). The complication rate in our series was 24% (n = 24) and higher in elderly patients (p = 0.03) and in patients with longer operating times (p = 0.03). Prolonged air leaks were observed in 10, and arrhythmia developed in nine patients. Two patients died, due to a concurrent lymphoblastic leukemia diagnosed at the postoperative period and exacerbation of interstitial fibrosis, respectively.
  
  
  CONCLUSIONS
  Robotic pulmonary resections prove to be safe and effective even at the initial learning experience. The duration of operations is considered to be acceptable. The learning curve could be established after 14 cases.
authors.affiliation: Department of Thoracic Surgery, Istanbul Bilim University and Group Florence Nightingale Hospital, Abide-i Hürriyet Cad. No: 166, Şişli, Istanbul, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Toker
authors.affiliation: Department of Thoracic Surgery, Istanbul Bilim University and Group Florence Nightingale Hospital, Abide-i Hürriyet Cad. No: 166, Şişli, Istanbul, Turkey. moozyurtkan@hotmail.com.
authors.forename: Mehmet Oğuzhan
authors.initials: MO
authors.lastname: Özyurtkan
authors.affiliation: Department of Thoracic Surgery, Istanbul Bilim University and Group Florence Nightingale Hospital, Abide-i Hürriyet Cad. No: 166, Şişli, Istanbul, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Kaba
authors.affiliation: Department of Thoracic Surgery, Istanbul Bilim University and Group Florence Nightingale Hospital, Abide-i Hürriyet Cad. No: 166, Şişli, Istanbul, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Ayalp
authors.affiliation: Department of Thoracic Surgery, Istanbul Bilim University and Group Florence Nightingale Hospital, Abide-i Hürriyet Cad. No: 166, Şişli, Istanbul, Turkey.
authors.forename: Özkan
authors.initials: Ö
authors.lastname: Demirhan
authors.affiliation: Department of Thoracic Surgery, Istanbul Bilim University and Group Florence Nightingale Hospital, Abide-i Hürriyet Cad. No: 166, Şişli, Istanbul, Turkey.
authors.forename: Elena
authors.initials: E
authors.lastname: Uyumaz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D059032:Learning Curve; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017063:Outcome Assessment, Health Care; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*
keywords: Learning curve; Pulmonary surgical procedure; Robotic surgical procedures; Treatment outcome