Robot Docking Time: Cumulative Summation Analysis of a Procedure-Independent Learning Curve in Pediatric Urology

Abstract

PURPOSE: The learning curve is an important method of assessment of progression in the use of a new technique or device and, in the field of robotic surgery, is most commonly described for individual procedures, often concentrating on console time and outcomes. We contemplated whether a learning curve of the similar nature and duration was exhibited in the procedure-independent variable of docking time. MATERIALS AND METHODS: The time from first incision to end of robot docking was found for a single surgeon's first 55 robotic cases, which encompassed a range of pediatric urological procedures. Raw and cumulative summation (CUSUM) data were found and plotted, with learning- and maintenance-phase times compared statistically. RESULTS: A classical learning curve of ∼30 cases was found with a statistically significant reduction in time between learning and maintenance phases. CONCLUSIONS: A learning curve of similar nature and duration to procedure-specific analyses was found for docking time. The variability of port placement and robot positioning for multiple procedures further increases the significance of this result.