Portal de Periódicos da CAPES

Robotic Surgery

2014; Lippincott Williams & Wilkins; Volume: 123; Issue: Supplement 1 Linguagem: Inglês

10.1097/01.aog.0000447070.70824.09

1873-233X

Mahate A. Parker, Tiffany DiGiacomo, Katherine Shepherd, Michael O. Gardner, Nora Doyle,

Anatomy and Medical Technology

INTRODUCTION: Hysterectomy is the most common major operation for women in the United States and an integral component of resident training. Recently, robotic-assisted hysterectomy has been introduced. We sought to measure the effect of robotic surgery on obstetrics–gynecology resident surgical experience. METHODS: After institutional review board approval, a retrospective cohort of all graduating residents during the time period 2009–2012 was analyzed for total number of surgical cases and resident role as primary surgeon using data from Accreditation Council for Graduate Medical Education Oplogs and electronic medical records and billing codes. Sixteen residents were identified and stratified by year of graduation, 2009–2010–2011–2012 and compared knowing robot introduction occurred in approximately 2011. Statistical analyses performed using NCSS software with P<.05 considered significant. RESULTS: Total number of hysterectomies with the resident as primary surgeon decreased over the study period 1,171–1,426–1,407–781 (P=.02). A decrease in abdominal approach was seen: 1,152–892–834–385 (P=.001). Vaginal numbers remained stable. Other laparotomy cases decreased 1,035–905–562–388 (P=.001). A trend increase for laparoscopic cases coincided with the laparotomy decrease. CONCLUSIONS: The introduction of the robotic-assisted hysterectomy has changed the resident surgical experience, arguably for the worse. Laparotomy experience at our institution reflects national decreasing trends. Resident as primary surgeon may decrease with robot use as attending surgeons are learning the skill set. The decrease in total numbers, coupled with the increase in the variety of hysterectomies, may affect resident surgical skills. Along with the limitations of resident work hours, these changes may require a more rigorous assessment of surgical competency before graduation.