American Board of Surgery Statement on Assessment and Robotic Surgery

Abstract

BackgroundAdoption of robotic systems for minimally invasive surgical procedures has increased in the last two decades. Over 19,000 papers have been written about robotic surgery in many subspecialties including general, thoracic, colorectal, urology, and gynecology. The only robotic interface currently approved by the US Food and Drug Administration for use is the Da Vinci Surgical System (Intuitive Surgical Inc., Sunnyvale, California). By the end 2017, Intuitive Surgical hadshipped 5770 robot systems, and counting for tradeins and returns, 4409 platforms had been installed worldwide. There were estimated to be 877, 000 robotic procedures in 2017, among which there were 252,000 general surgery cases, the specialty with the greatest volume increase as compared to other surgical specialties. 1 The Education and Training Council Committee (ETCC) of the American Board of Surgery was tasked by the ABS Board of Directors to create a statement regarding robotics as core of surgery training that should apply across specialties. This represents a summary of the recommendations of the ETCC.

Laparoscopic but not open surgical skills can be transferred to robot‐assisted surgery: A systematic review and meta‐analysis

“…Current Accreditation Council for Graduate Medical Education requirements include 100 basic and 75 complex laparoscopic procedures to be performed during general surgery residency. However, the number of robotic procedures is not specified and generally falls within the complex laparoscopic procedures 8 . The American Association of Gynecologic Laparoscopists, requires that surgeons perform gynecological procedures without robotic assistance before performing any procedures using a robotic surgical system 9 while the European Association of Urology requires neither previous open nor laparoscopic surgical experience 10 .…”

“…However, the number of robotic procedures is not specified and generally falls within the complex laparoscopic procedures. 8 The American Association of Gynecologic Laparoscopists, requires that surgeons perform gynecological procedures without robotic assistance before performing any procedures using a robotic surgical system 9 while the European Association of Urology requires neither previous open nor laparoscopic surgical experience. 10 This heterogeneity in credentialing surgeons for robotassisted surgery can be partially traced back to the still unknown impact of laparoscopic surgery on robotassisted surgery.…”