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Learning Curves of Robotic Spine Surgery in a System Lack of Active Perception: Potential Roles of Teamwork and Unmet Needs

Authors :
Yu-feng Su
Tai-Hsin Tsai
Keng-Liang Kuo
Chieh-Hsin Wu
Cheng-Yu Tsai
Yen-Mou Lu
Shiuh-Lin Hwang
Pei-Chen Lin
Ann-Shung Lieu
Chih-Lung Lin
Chih-Hui Chang
Publication Year :
2021
Publisher :
Research Square Platform LLC, 2021.

Abstract

Background: The aim of this study was to investigate the learning curve of robotic spine surgery quantitatively with the well-described power law of practice.Methods: Kaohsiung Medical University Hospital set up a robotic spine surgery team by the neurosurgery department in 2013 and the orthopedic department joined the well-established team in 2014. A total of 150 cases and 841 transpedicular screws were enrolled into 3 groups: the first 50 cases performed by neurosurgeons, the first 50 cases by orthopedic surgeons, and 50 cases by neurosurgeons after the orthopedic surgeons joined the team. The time per screw and accuracy by each group and individual surgeon were analyzed.Results: The time per screw for each group was 9.56±4.19, 7.29±3.64, and 8.74±5.77 minutes respectively. The accuracy was 99.6% (253/254), 99.5% (361/363), and 99.1% (222/224), respectively. The first group took significantly more time per screw, but without significance on the nonlinear parallelism test. Analysis of 5 surgeons and their first 10 cases of short segment surgery showed the time per screw by each surgeon was 12.28±5.21, 6.38±1.54, 8.68±3.10, 6.33±1.90, and 6.73±1.81 minutes. The first surgeon who initiated the robotic spine surgery took significantly more time per screw and the nonlinear parallelism test also revealed only the first surgeon had a steeper learning curve. Conclusions: This is the first study to demonstrate that differences of learning curves between individual surgeons and teams. The roles of teamwork and the unmet needs due to lack of active perception are discussed.

Details

Database :
OpenAIRE
Accession number :
edsair.doi...........f662604856d379a464c8fdfe2f7c8664