The learning curve of robot-assisted laparoscopic aortofemoral bypass grafting for aortoiliac occlusive disease



Year of publication 2011
Type Article in Periodical
Magazine / Source Journal of Vascular Surgery
MU Faculty or unit

Faculty of Medicine

Field Surgery incl. transplantology
Keywords Robot-assisted vascular surgery; Aortoiliac occlusive disease; Learning curve
Description Background: Our objective was to assess the learning curve of robot-assisted laparoscopic aortofemoral bypass grafting in a group of 40 patients. Methods: Learning curve estimations were used for anastomosis, clamping, and operative time assessment. For conversion rate evaluation the cumulative summation (CUSUM) technique was used. Results: We created 21 aortofemoral and 19 aortobifemoral bypasses. The median proximal anastomosis time was 23 minutes, clamping time 60 minutes and operative time 295 minutes. Secondary patency was 100%. Data showed a typical short learning curve for robotic proximal anastomosis. The operative time learning curve confirmed the procedure’s complexity. Acceptable conversion rate set at 5% was achieved. Conclusions: Anastomosis creation, one of the main difficulties of laparoscopic bypass grafting, has been overcome. The endoscopic dissection of the aortoiliac segment remains the most difficult part of the operation.

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