2005 SAGES Abstracts

POSTER ABSTRACTS
SAGES 2005
10.6 min. (range 21-49 min.). The mean robot time was 110 +/-
44.6 min (range 74-229 min.). The mean LOS was 1.54 +/- 1.1
days (range 1-5 days). Two failures occurred: chronic coughing
(1) and retching with the flu (1). This early experience suggests
that robotic assistance is a safe and feasible adjunct to the
treatment of GERD. The port setup time was stable. The operative
and robotic times had similar patterns and improved with
greater experience. Future investigations warrant a comparison
to laparoscopic Nissen Fundoplication.
P394–Robotics
ROBOTIC ASSISTED COLON RESECTIONS: 23 CASES, Arthur
L Rawlings MD, Jay H Woodland MD,David L Crawford MD,
Division of Minimally Invasive Surgery, Dept. of Surgery ,
University of Illinois College of Medicine at Peoria
This study describes the experience, advantages, and disadvantages
of using robotic assistance for a colectomy based on
23 consecutive cases by a MIS fellowship trained surgeon.
Since the introduction of the DaVinci Robotic System, minimally
invasive surgeons have explored the feasibility of its use
for a variety of procedures. This study was based on information
that was prospectively collected in an Access database
from 9/2002 to the present. Data analyzed included indications
for surgery, demographics, and operative times using range,
mean, and standard deviations. There were 12 males and 11
females. Patient age: average 60.0 ± 13.7; range [32-83].
Operations included 12 sigmoid colectomies with splenic flexure
mobilization and 11 right colectomies. Preop diagnosis:
Cancer (4); Diverticulitis (8); Polyp (10); Carcinoid (1). Port
setup time in minutes: ave 31.1 ± 7.9; [17-50]. Total robot operating
time in minutes: ave 147.7 ± 59.8; [69-306]. Total case
time in minutes: ave 245.2 ± 45.7; [147-380]. Length of stay in
days: ave 6.0 ± 7.0; [2-30]. One case was converted to open
secondary to dense bladder/sigmoid colon adhesions. Six
complications were encountered: 1) Patient slid off OR table to
floor after the robotic portion of the procedure; 2) Persistent
left hip parasthesia; 3) Transverse colon injury from ultrasound
shears; 4) Cecal injury from cautery; 5) Anastomotic leak; 6)
Urinary retention beginning POD 5. Advantages of robotic
assistance were: 1) Enhanced visualization of the operative
field; 2) Wristed instrumentation facilitated dissection; 3)
Camera controlled by operating surgeon; 4) Reduced surgeon?s
fatigue; 5) Increased marketability of surgeon as
?regional MIS expert.? Disadvantages specific for this procedure
included: 1) Inconvenience of altering port placement of
camera/instruments during the case; 2) Difficulty working in far
lateral extensions of the operative field; 3) Difficulty changing
table position during procedure. Robotic assisted colon resections
are feasible as demonstrated in this series with the
above-mentioned advantages and disadvantages.
P395–Robotics
A NOVEL DRILL SET ALLOWS ASSESSMENT OF ROBOTIC
SURGICAL PERFORMANCE, Charles Y Ro MD, James J
McGinty MD,Joseph J DeRose MD,Ioannis K Toumpoulis
MD,Celina Imielinska PhD,Tony Jebara PhD,Seung H Shin
MD,Haroon L Chughtai MD,George J Todd MD,Robert C
Ashton MD, St. Luke’s-Roosevelt Hospital Center, Columbia
University
Inanimate simulation is a useful tool in overcoming the learning
curve of minimal access surgery. Unique skills are required
for mastery of robotically assisted minimal access surgery. We
have developed inanimate exercises to simulate and assess
the skills necessary for robotic surgery.
Expert surgeons (n=4) (> 50 clinical robotic procedures and > 2
years of clinical robotic experience) were compared to novice
surgeons (n=17) (< 5 clinical cases and limited laboratory
experience) using the da Vinci Surgical System. Seven drills
were designed to simulate clinical robotic surgical tasks. Time
to completion, minor errors and major errors were recorded
for the appropriate drill. Performance score was calculated by
the equation Time to Completion + (minor error) x 5 + (major
error) x 10. The Robotic Learning Curve (RLC) consists of a
trend line of the performance scores corresponding to each
repeated drill. Data was analyzed with the Friedman Test and
Mann-Whitney U Test.
Performance scores for experts were better than novices in all
230 http://www.sages.org/
7 drills (p