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{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T04:17:21Z","timestamp":1689221841043},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T00:00:00Z","timestamp":1681776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T00:00:00Z","timestamp":1681776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100018936","name":"Universit\u00e4tsklinikum Heidelberg","doi-asserted-by":"crossref"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n <jats:title>Background<\/jats:title>\n <jats:p>Initial learning curves are potentially shorter in robotic-assisted surgery (RAS) than in conventional laparoscopic surgery (LS). There is little evidence to support this claim. Furthermore, there is limited evidence how skills from LS transfer to RAS.<\/jats:p>\n <\/jats:sec><jats:sec>\n <jats:title>Methods<\/jats:title>\n <jats:p>A randomized controlled, assessor blinded crossover study to compare how RAS na\u00efve surgeons (<jats:italic>n<\/jats:italic>\u2009=\u200940) performed linear-stapled side-to-side bowel anastomoses in an in vivo porcine model with LS and RAS. Technique was rated using the validated anastomosis objective structured assessment of skills (A-OSATS) score and the conventional OSATS score. Skill transfer from LS to RAS was measured by comparing the RAS performance of LS novices and LS experienced surgeons. Mental and physical workload was measured with the NASA-task load index (NASA-Tlx) and the Borg-scale.<\/jats:p>\n <\/jats:sec><jats:sec>\n <jats:title>Outcomes<\/jats:title>\n <jats:p>In the overall cohort, there were no differences between RAS and LS for surgical performance (A-OSATS, time, OSATS). Surgeons that were na\u00efve in both LS and RAS had significantly higher A-OSATS scores in RAS (Mean (Standard deviation (SD)): LS: 48.0\u2009\u00b1\u200912.1; RAS: 52.0\u2009\u00b1\u20097.5); <jats:italic>p<\/jats:italic>\u2009=\u20090.044) mainly deriving from better bowel positioning (LS: 8.7\u2009\u00b1\u20091.4; RAS: 9.3\u2009\u00b1\u20091.0; <jats:italic>p<\/jats:italic>\u2009=\u20090.045) and closure of enterotomy (LS: 12.8\u2009\u00b1\u20095.5; RAS: 15.6\u2009\u00b1\u20094.7; <jats:italic>p<\/jats:italic>\u2009=\u20090.010). There was no statistically significant difference in how LS novices and LS experienced surgeons performed in RAS [Mean (SD): novices: 48.9\u2009\u00b1\u20099.0; experienced surgeons: 55.9\u2009\u00b1\u200911.0; <jats:italic>p<\/jats:italic>\u2009=\u20090.540]. Mental and physical demand was significantly higher after LS.<\/jats:p>\n <\/jats:sec><jats:sec>\n <jats:title>Conclusion<\/jats:title>\n <jats:p>The initial performance was improved for RAS versus LS for linear stapled bowel anastomosis, whereas workload was higher for LS. There was limited transfer of skills from LS to RAS.<\/jats:p>\n <\/jats:sec>","DOI":"10.1007\/s00464-023-10044-7","type":"journal-article","created":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T16:03:03Z","timestamp":1681833783000},"page":"5894-5901","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Robotic-assisted versus laparoscopic bowel anastomoses: randomized crossover in vivo experimental study"],"prefix":"10.1007","volume":"37","author":[{"given":"Cael\u00e1n Max","family":"Haney","sequence":"first","affiliation":[]},{"given":"Karl-Friedric
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