Background

The da Vinci surgical system has been shown to reduce postoperative pain and length of stay in patients with obesity in addition to improvement in ergonomics and visualization for surgeons. Nationally, the adoption rate for robotic surgery in obesity has increased to 38% in 2022 from 17% in 2020 with a predicted adoption rate of approximately 50% by the end of 2023. This growth is likely due to the FDA approval of the Sureform 60 mm stapler from Intuitive Robotics in 2018. This study evaluates the learning curve for robotic sleeve gastrectomy from the time of incision to head-in on the console.

Methods

Robotic-assisted sleeve gastrectomy was completed in 37 consecutive patients from July 2018 to July 2019 at a single institution under one surgeon and two different bariatric surgery fellows. The time from incision to head-in on the console (docking time) was evaluated in a standard 4-port robotic sleeve gastrectomy.

Results

The average time was 22.8 minutes from incision to head-in for robotic sleeve gastrectomy in 37 cases. After 19 cases, the average time decreased significantly to 16.5 minutes. The minimal time was 14 minutes while maximal time was 38 minutes.

Conclusions

The da Vinci surgical system offers substantial benefits to surgeons with an improvement in ergonomics and visualization especially in patients with obesity. After 19 consecutive cases, the learning curve demonstrated a decrease in the average time from incision to head-in on the console.