• J. Thorac. Cardiovasc. Surg. · Aug 2011

    Learning curve analysis of mitral valve repair using telemanipulative technology.

    • Patrick J Charland, Tom Robbins, Evilio Rodriguez, Wiley L Nifong, and Randolph W Chitwood.
    • East Carolina Heart Institute, Greenville, NC, USA. pjc1020@yahoo.com
    • J. Thorac. Cardiovasc. Surg. 2011 Aug 1; 142 (2): 404-10.

    ObjectiveTo determine if the time required to perform mitral valve repairs using telemanipulation technology decreases with experience and how that decrease is influenced by patient and procedure variables.MethodsA single-center retrospective review was conducted using perioperative and outcomes data collected contemporaneously on 458 mitral valve repair surgeries using telemanipulative technology. A regression model was constructed to assess learning with this technology and predict total robot time using multiple predictive variables. Statistical analysis was used to determine if models were significantly useful, to rule out correlation between predictor variables, and to identify terms that did not contribute to the prediction of total robot time.ResultsWe found a statistically significant learning curve (P < .01). The institutional learning percentage∗ derived from total robot times† for the first 458 recorded cases of mitral valve repair using telemanipulative technology is 95% (R(2) = .40). More than one third of the variability in total robot time can be explained through our model using the following variables: type of repair (chordal procedures, ablations, and leaflet resections), band size, use of clips alone in band implantation, and the presence of a fellow at bedside (P < .01).ConclusionsLearning in mitral valve repair surgery using telemanipulative technology occurs at the East Carolina Heart Institute according to a logarithmic curve, with a learning percentage of 95%. From our regression output, we can make an approximate prediction of total robot time using an additive model. These metrics can be used by programs for benchmarking to manage the implementation of this new technology, as well as for capacity planning, scheduling, and capital budget analysis.Copyright © 2011 The American Association for Thoracic Surgery. All rights reserved.

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