Abstract
Objective:
This research assessed if attending surgical volume impacted the relationship between resident participation and operative time in robotic surgery for benign gynecologic conditions.
Materials and Methods:
This retrospective cohort study included 1 academic and 1 community hospital, where a total of 329 patients underwent robotic surgery for benign gynecologic conditions from January 2018 to March 2019. The primary outcome was total operative time. The primary exposure was resident participation versus nonparticipation in robotic cases. The patients were operated on by 3 surgeons from the same group. The lifetime robotic hysterectomy volumes were 1250 (over 11 years), 146 (over 8 years), and 107 (over 8 years), respectively for the 3 surgeons.
Results:
The unadjusted mean total operative time was longer for cases involving residents (130.3 minutes [95% confidence interval (CI): 122.8–137.7 minutes] versus 109.6 minutes [95% CI: 104.0–115.3 minutes]; p < 0.001). Among hysterectomy cases, the adjusted mean total operative time was 22.3 minutes longer for cases with resident participation versus no participation (95% CI: 11.9–32.7 minutes longer; p < 0.001). Among hysterectomy cases, the mean total operative time for the high-volume surgeon increased by 14.9 minutes with resident participation, compared to an increase of 45.3 minutes for his 2 low-volume partners.
Conclusions:
This retrospective chart review's results suggest that attending surgeon robotic volume and surgery type appear to mediate the relationship between resident participation in robotic surgery and total operative time. More research is needed to confirm these findings. (J GYNECOL SURG 37:303)
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