1960 The Impact of Resident Participation on Operating Time in Robotic Surgery for Benign Gynecological Conditions

Abstract

Study Objective To assess the association between resident participation and operative time in robotic surgery for benign gynecological conditions. Design A retrospective cohort study. Setting Two hospitals in Las Vegas, Nevada (one is a teaching hospital and one is not). Patients or Participants A total of 329 patients who underwent robotic surgery for benign gynecologic conditions from January 2018 to March 2019. All cases were performed by a single high volume robotic surgeon. Interventions Resident participation (versus non-participation) in 41.6% of 329 robotic cases. Measurements and Main Results The primary outcome was the total operative time. The primary exposure was resident participation versus non-participation in the robotic case. In our primary analysis we compared the mean and median operative times for cases with versus without resident participation. We then constructed a regression model to adjust for potential confounders including age, body mass index (BMI), specimen weight (in grams) and whether the surgery was a hysterectomy or not. There were no baseline differences in patient characteristics between cases involving residents and those not involving residents. In unadjusted analysis, the mean operative time was longer for cases involving residents (130.3 minutes [95% CI 122.8-137.7 minutes] vs 109.6 minutes [95% CI 104.0-115.3 minutes], p Conclusion Consistent with a prior study looking at trainee participation in gynecologic oncology cases performed robotically, we found that resident participation in robotic cases for benign gynecologic surgical conditions was associated with an increased operative time of approximately 20 minutes, even adjusting for age, BMI, type of surgery (hysterectomy vs. other type) and specimen weight.