An analysis of operating time over the years for robotic-assisted surgery in gynecology and gynecologic oncology.

Robotic-assisted surgery has a shorter learning curve enabling the surgeons to do complex surgeries in a minimally invasive way. This study analyzed how the time taken for robotic-assisted procedures in gynecology and gynecologic oncology has changed over the years in a university teaching institution. Details were taken from a prospectively maintained electronic database after obtaining permission from the hospital ethics committee. All patients who underwent robotic surgery for gynecologic problems at this center from February 2015 till December 2019 were included. The clinical, perioperative, postoperative and pathologic details were collected from the prospectively maintained database. To analyze quantitative data, student t test was used. Chi-square test was performed to compare categorical variables. 655 patients underwent robotic-assisted surgery during this period. The majority of the patients underwent surgery for uterine cancer (49%). There was a significant improvement in total surgical time (250 vs. 165 min), docking time (12.6 vs 8.9 min), and console time (130 vs. 95 min) between the first and second year (2015-16). The next 2 years (2017 and 18) did not show a significant decrease in the total surgery time and console time, but docking times improved in 2017 (5.5 vs 8.5 min) compared to 2016. In 2019, there was a significant improvement in all surgical times compared to previous years. This study shows that robotic surgery has a lot of scope for improvement in surgical performance beyond its first and second years. The surgical performance as seen from the improved surgical times keeps on improving even after many years.