Defining the learning curve in robot-assisted thoracoscopic lobectomy

Abstract

Background: Robot-assisted thoracoscopic lobectomy has been shown to be a safe approach to pulmonary lobectomy. This study sought to define, mathematically, the learning curve for RATS lobectomy. Methods: Patients undergoing robot-assisted thoracoscopic lobectomy at a single institution from 2010 through 2016 were considered. Covariates included patient demographics, comorbidities, operating time, length of stay, estimated blood loss, and postoperative complications. A cumulative sum analysis of operating time was performed to define the learning curve. Results: A total of 101 patients were included. Three distinct phases of the learning curve were identified: cases 1–22, cases 23–63, and cases 64–101. There was a statistically significant difference in operating time and estimated blood loss between phases 1 and 2 (P