A learning curve analysis of domestic robot-assisted thyroid surgery via BABA approach
10.3760/cma.j.cn115807-20241029-00330
- VernacularTitle:国产机器人辅助下经BABA入路行甲状腺手术的学习曲线分析
- Author:
Jing XU
1
;
Peng ZHOU
1
;
Yongxiang LIU
1
;
Jian ZHU
1
;
Meng WANG
1
;
Gang WANG
1
;
Dayong ZHUANG
1
;
Qingqing HE
1
Author Information
1. 中国人民解放军联勤保障部队第九六〇医院甲状腺乳腺外科,济南 250031
- Publication Type:Journal Article
- Keywords:
Domestic robot;
BABA approach;
Thyroid surgery;
Learning curve;
Robosurgeon
- From:
Chinese Journal of Endocrine Surgery
2025;19(4):503-508
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarise the main points of operation during thyroid surgery using bilateral axillo-breast approach (BABA) with a domestic robot and to analyse the learning curve.Methods:From May. 2023 to Oct. 2023, we retrospectively analysed the clinical data of 38 patients who underwent thyroid surgery with domestically manufactured robot via BABA attending the Department of Thyroid and Breast Surgery of the 960th Hospital of PLA Joint Logistics Support Force, proposed and constructed learning curves using cumulative and analytical methods to study the minimum number of learning cases required for the loading time of assistants and surgeon-in-charge with da Vinci surgical experience to transition from the initial learning stage to the proficiency stage. The age, BMI, surgical time (loading time, operating time), postoperative drainage time, and number of lymph nodes dissected were compared among patients at different stages of the learning curve.Results:A total of 38 thyroidectomy patients successfully underwent surgery, with an average surgical time of (176.61 ± 47.98) minutes. After 18 cases, the assistant's loading time shortened and stabilized at (42.20 ± 3.44) minutes. The operator reached peak proficiency at the 18th case (loading time, operating time), which was considered the dividing point between the learning phase and the proficiency phase. During the learning phase, the average surgical time was (209.72 ± 49.28) minutes, operation time: (165.44 ± 49.93) minutes, while in the proficiency phase, the average surgical time decreased to 146.80 ± 18.34 minutes, operation time: (104.60 ± 19.01) minutes. There were no statistically significant differences in baseline characteristics such as age, BMI, postoperative drainage time, or the number of central compartment lymph nodes dissected between the two phases ( P > 0.05) . Conclusion:Over the results of this study, it was shown that for robosurgeons with experience in da Vinci robotic surgery, the transition from the learning stage to the proficiency stage could be considered after crossing the learning curve for 18 cases, and that assistants could become proficient in loading techniques after 18 procedures.