Impact of robotic general surgery course on participants’ surgical practice

Abstract

Background Courses, including lectures, live surgery, and hands-on session, are part of the recommended curriculum for robotic surgery. However, for general surgery, this approach is poorly reported. The study purpose was to evaluate the impact of robotic general surgery course on the practice of participants. Methods Between 2007 and 2011, 101 participants attended the Geneva International Robotic Surgery Course, held at the University Hospital of Geneva, Switzerland. This 2-day course included theory lectures, dry lab, live surgery, and hands-on session on cadavers. After a mean of 30.1 months (range, 2-48), a retrospective review of the participants' surgical practice was performed using online research and surveys. Results Among the 101 participants, there was a majority of general (58.4 %) and colorectal surgeons (10.9 %). Other specialties included urologists (7.9 %), gynecologists (6.9 %), pediatric surgeons (2 %), surgical oncologists (1 %), engineers (6.9 %), and others (5.9 %). Data were fully recorded in 99 % of cases; 46 % of participants started to perform robotic procedures after the course, whereas only 6.9 % were already familiar with the system before the course. In addition, 53 % of the attendees worked at an institution where a robotic system was already available. All (100 %) of participants who started a robotic program after the course had an available robotic system at their institution.Conclusions A course that includes lectures, live surgery, and hands-on session with cadavers is an effective educational method for spreading robotic skills. However, this is especially true for participants whose institution already has a robotic system available.Keywords Robot Á Course Á Training Á General surgery Á Practice After laparoscopy, robotics has revolutionized the minimally invasive approach in surgery. Many advanced and complex procedures have been reported to be feasible and safe by a robotic approach [1][2][3][4][5], whereas their laparoscopic counterparts were done before only by exceptionally skillful surgeons [6].As the evidence for clinical safety and advantages of robotic surgery continues to be collected [7][8][9], the demand for training will continue to increase. This new challenge was clearly described by several authors [10,11]. The recommended curriculum for robotic surgery is still debated, and the different societies for minimally invasive surgery collaborate to draw a consistent training module [12,13]. Moreover, the initial training on the robot might be difficult, because the teaching surgeon has reduced direct control [14]. Yet, it seems relatively clear that the training courses should include lectures, live surgery, and hands-on session. For urology, several groups [14][15][16][17][18][19] have reported their experience and the impact of structured courses on the participants' practice. However, for general surgery, this approach has been poorly evaluated so far.At our institution, we started our robotic activity in 2006, and since 2007 our division has proposed r...

Current status of robotic training in the UK – a trainees perspective

“…12 Training programmes Robotic training programmes which use a combination of tutorials, observation of live surgery and skills training with simulation have been described (see Figure 2). 11,14,16,17 The Fundamental Skills in Robotic Surgery (FSRS) training programme was created using curriculum exercises from the Fundamentals of Laparoscopic Surgery (FLS) course. A short tutorial on the usage of the Da Vinci Surgical Simulator (DvSS) was followed by three main skills tests; suture pass, ball skills and 4th arm manipulation.…”

“…Participants who had completed the course went on to practice robotic surgery in 46% of cases whereas only 6% did so pre-course. 17 For more advanced training and education Rashid et al have presented their approach to robotic training in a fellowship setting beginning with Da Vinci certification followed by Volume stepwise introduction of practical hands on experience in the steps of prostatectomy with progress measured using a 1-5 analogue scale. Each assessment was logged in a digitally maintained diary.…”

Introductory Chapter: Advances in Minimally Invasive Surgery

“…The da Vinci Standard surgical system was introduced early in the twentieth century. This robotic system was used in some field of surgery as urology, digestive surgery, and cardiothoracic surgery [5,6]. The next-generation surgical system was introduced in the following years with field indications were enlarged as follows: general surgery, gynecology, and otolaryngology.…”

“…It was found that the use of robotic surgery increased rapidly across numerous different procedures after hospitals begin performing robotic surgery. This trend was associated with a decrease in the use of laparoscopic minimally invasive procedures, which for most surgeons was already considered a safe and effective approach when clinically feasible [5,6]. The advent of robotic surgery has certainly brought further advances in the field of mini-invasive surgery.…”

Expert consensus on a train‐the‐trainer curriculum for robotic colorectal surgery

“…In the last few years, robotically assisted techniques have also increasingly been used for resections of the colon and rectum . Robotic techniques were developed to overcome some of the limitations of conventional laparoscopic instruments by providing increased range and precision of instrument movements, a stable camera position with magnified three‐dimensional imaging and avoidance of the fulcrum effect .…”