655 Robotic-Assisted Breast-Axillo Insufflation Thyroidectomy (RABIT)

Dr. Ameenuddin Khan

Problem – identify learning curve to attain Technical (surgical duration) and Functional proficiency (post operative hypoparathyroidism) in robotic thyroidectomy Solution – A total of 101 consecutive patients undergoing either total or hemithyroidectomy for benign and malignant conditions were included. Cumulative Sum (CUSUM) analysis was performed to evaluate the learning curve for the procedure. Sixth order Polynomial curve was used identify the breakpoint of 32 cases to attain technical proficiency. Linear regression analysis was used to identify further breakpoints – initial training (1-8 cases), transition phase (9-32 cases) and proficiency phase (> 32 cases). However, 60 cases were required to attain a stable uptrend in the PTH levels for this procedure i.e., functional proficiency. Innovative findings – Technical and functional proficiencies are independent of each other. Functional proficiency has a longer learning curve than technical proficiency. Identification of both breakpoints is vital for any innovative surgical procedure
Procedure innovation, Otolaryngological surgery (Head & Neck), robotic thyroidectomy

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