Pediatric Robotic Surgery: From Observation to Autonomy in a Motion-Based Assessment of Learning Curve Using a Dual-Console System

Le résumé fourni par la source

Introduction: Objective data quantifying the trend of the robotic-assisted learning process remains limited. The aim of this study is to evaluate the efficiency and progression of surgical skill acquisition during robotic-assisted pyeloplasty by comparing performance parameters between expert and non-expert surgeons using a dual-console system over a 3-year period. Methods: A total of 25 robotic-assisted pyeloplasties were retrospectively analyzed; all were performed by a Da Vinci Xi robotic platform equipped with dual operative consoles, operated simultaneously by a robotic expert (C1) and a non-expert surgeon (C2). The procedures were divided into five standardized phases. Surgical performance was assessed using Tracker ® motion analysis software, which measured operative times, console utilization, instrument collisions, and motion efficiency. Trends across years were assessed using one-way analysis of variance ( P < .05). Results: A total of 25 cases were analyzed. The total operative time decreased significantly from 210 minutes in year 1 to 185 minutes in year 3 ( P = .008). The expert surgeon’s console time ratio decreased from 90.0% in year 1 to 14.5% in year 3 ( P < .001), with a corresponding increase in non-expert surgeon’s console time. A significant reduction in the number of instrument collisions (from 1457 in year 1 to 97 in year 3, P < .001) and a marked increase in motion efficiency (from 14% to 88%, P < .001) were observed for the non-expert surgeon. Phase-specific analysis revealed a steady improvement in the non-expert surgeon’s performance across all phases. Conclusions: Robotic-assisted pyeloplasty significantly accelerates skill acquisition for non-expert surgeons, as evidenced by improvements in operative time, instrument collisions, and motion efficiency. The dual-console approach provides a valuable educational framework, facilitating real-time supervision and progressive task delegation. These findings support integrating dual-console systems and objective motion analysis into structured robotic training programs to enhance surgical proficiency and safety in pediatric surgery.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.