Correction to: Evolution of a Novel Robotic Training Curriculum in a Complex General Surgical Oncology Fellowship

Knab, Lawrence M.; Zenati, Mazen S.; Khodakov, Anton; Rice, MaryJoe K.; Abbas, Amr I. Al; Bartlett, David L.; Zureikat, Amer H.; Zeh, Herbert J.; Hogg, Melissa E.

doi:10.1245/s10434-018-07106-9

Cited by 13 publications

(13 citation statements)

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“…First, validated curricula have been developed for RPD, and are being integrated into both residency and fellowship training programs. 40,41 These curricula might be preferentially steering new adopters of MI-PD toward the robotic platform which is perhaps less technically demanding on surgeons compared with laparoscopy. Moreover, the negative results of the LEOPARD-2 trial and the minimal clinical benefits observed in the recent Chinese randomized controlled trial reported by Wang and colleagues might be also contributing to a general decreasing interest toward LPD.…”

Section: Discussionmentioning

confidence: 99%

Robotic Pancreaticoduodenectomy: Increased Adoption and Improved Outcomes

et al. 2022

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Objective: To compare the rate of postoperative 30-day complications between laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD). Background: Previous studies suggest that minimally invasive pancreaticoduodenectomy (MI-PD)—either LPD or RPD—is noninferior to open pancreaticoduodenectomy in terms of operative outcomes. However, a direct comparison of the two minimally invasive approaches has not been rigorously performed. Methods: Patients who underwent MI-PD were abstracted from the 2014 to 2019 pancreas-targeted American College of Surgeons National Sample Quality Improvement Program (ACS NSQIP) dataset. Optimal outcome was defined as absence of postoperative mortality, serious complication, percutaneous drainage, reoperation, and prolonged length of stay (75th percentile, 11 days) with no readmission. Multivariable logistic regression models were used to compare optimal outcome of RPD and LPD. Results: A total of 1540 MI-PDs were identified between 2014 and 2019, of which 885 (57%) were RPD and 655 (43%) were LPD. The rate of RPD cases/year significantly increased from 2.4% to 8.4% (P=0.008) from 2014 to 2019, while LPD remained unchanged. Similarly, the rate of optimal outcome for RPD increased during the study period from 48.2% to 57.8% (P<0.001) but significantly decreased for LPD (53.5% to 44.9%, P<0.001). During 2018–2019, RPD outcomes surpassed LPD for any complication [odds ratio (OR)=0.58, P=0.004], serious complications (OR=0.61, P=0.011), and optimal outcome (OR=1.78, P=0.001). Conclusions: RPD adoption increased compared with LPD and was associated with decreased overall complications, serious complications, and increased optimal outcome compared with LPD in 2018–2019.

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Section: Discussionmentioning

confidence: 99%

Robotic Pancreaticoduodenectomy: Increased Adoption and Improved Outcomes

et al. 2022

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“…This curriculum included virtual reality simulation, inanimate biotissue drills, video review, adaptive intraoperative coaching based on case logs and experience, and prospective assessment of operative performance and outcomes. [22][23][24][25][26] Data on fellow participation and which steps of each RPD they performed was recorded as part of the institutional prospective clinical database which facilitated assessment of trainee integration into the RPD program. 25…”

Section: Implementation Of the Robotic Training Curriculummentioning

confidence: 99%

500 Minimally Invasive Robotic Pancreatoduodenectomies

et al. 2019

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Objectives: This study aims to present the outcomes of our decade-long experience of robotic pancreatoduodenectomy and provide insights into successful program implementation. Background: Despite significant improvement in mortality over the past 30 years, morbidity following open pancreatoduodenectomy remains high. We implemented a minimally invasive pancreatic surgery program based on the robotic platform as one potential method of improving outcomes for this operation. Methods: A retrospective review of a prospectively maintained institutional database was performed to identify patients who underwent robotic pancreatoduodenectomy (RPD) between 2008 and 2017 at the University of Pittsburgh. Results: In total, 500 consecutive RPDs were included. Operative time, conversion to open, blood loss, and clinically relevant postoperative pancreatic fistula improved early in the experience and have remained low despite increasing complexity of case selection as reflected by increasing number of patients with pancreatic cancer, vascular resections, and higher Charlson Comorbidity scores (all P<0.05). Operating room time plateaued after 240 cases at a median time of 391 minutes (interquartile rang 340–477). Major complications (Clavien >2) occurred in less than 24%, clinically relevant postoperative pancreatic fistula in 7.8%, 30- and 90-day mortality were 1.4% and 3.1% respectively, and median length of stay was 8 days. Outcomes were not impacted by integration of trainees or expansion of selection criteria. Conclusions: Structured implementation of robotic pancreatoduodenectomy can be associated with excellent outcomes. In the largest series of RPD, we establish benchmarks for the surgical community to consider when adopting this approach.

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“…The literature search of curricular programs for robotic visceral surgery provided a total of 74 results after removal of duplicates. Of these, 17 studies were identified which included description of curricular teaching structures for robotic visceral surgery [2,4,12,14,16,[31][32][33][34][35][36][37][38][39][40][41][42][43] (Table 3). The relevant studies were screened regarding authors, journal and year of publication, personnel participation, simulator training, bedside assistance, console training, referring operations or organ systems, curricular phases or time periods, connection to residents' post-graduate year or any other connection to surgical experience and evaluation methods (Table 3).…”

Section: Resultsmentioning

confidence: 99%

RoCS: Robotic Curriculum for young Surgeons

et al. 2022

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Robotic-assisted procedures gain increasing acceptance for daily surgical routine. However, structured training programs are designed for surgeons with high expertise. Hence, a comprehensive training curriculum was established to ensure a basic competence in robotic abdominal surgery for young surgeons during their residency. The aim of the current work is to propose a feasible and effective training concept. The development process of this training curriculum is based on a comprehensive literature review which led to the concept of “robotic curriculum for young surgeons” (RoCS). It was implemented in the daily routine of a German university hospital starting in 2020. The robotic assessment questionnaire (RAQ) was used for electronic data collection. After the initial phase adjustments, it led to an improvement of the initial version of the curriculum. RoCS is a multimodal training program containing basic training through assistance at the operation table during robotic-assisted operations and basic console training. Key elements are the robotic team time-out (rTTO), perioperative process standardization including feasible personnel scheduling and useful procedure clustering into organ systems, procedural steps and procedural step complexity. Evaluation of standardized communication, performance assessment, patient factors and individual overall workload using NASA Task Load Index is realizable. Flexibility and adaptability to internal organization processes of surgical departments are the main advantages of the concept. RoCS is a strong training tool to meet the specific needs of young surgeons and evaluate their learning success of robotic procedural training. Furthermore, comparison within the different robotic systems should be considered. Further studies are needed to validate a multicenter concept design.

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Correction to: Evolution of a Novel Robotic Training Curriculum in a Complex General Surgical Oncology Fellowship

Cited by 13 publications

References 0 publications

Robotic Pancreaticoduodenectomy: Increased Adoption and Improved Outcomes

Robotic Pancreaticoduodenectomy: Increased Adoption and Improved Outcomes

500 Minimally Invasive Robotic Pancreatoduodenectomies

RoCS: Robotic Curriculum for young Surgeons

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