Long-Term Impact of a Robot Assisted Laparoscopic Prostatectomy Mini Fellowship Training Program on Postgraduate Urological Practice Patterns

Gamboa, Aldrin Joseph R.; Santos, Rosanne; Sargent, Eric R.; Louie, Michael K.; Box, Geoffrey N.; Sohn, Kevin H.; Truong, H. P.; Lin, Rachelle; Khosravi, Amanda; Santos, Ricardo; Ornstein, David K.; Ahlering, Thomas E.; Tyson, Darren R.; Clayman, Ralph V.; McDougall, Elspeth M.

doi:10.1016/j.juro.2008.10.018

Cited by 50 publications

(28 citation statements)

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“…Because of the significantly higher rates of patients with high-risk disease in their RRP cohort, their margin analysis was limited to low-and intermediate-risk patients. They found a positive surgical margin rate of 14% after RRP and 13% after RALP [13]. In the present study, we observed overall positive surgical margin rates of 14.4%, 13.0% and 19.5% for RRP, LRP and RALP, respectively.…”

Section: Discussionsupporting

confidence: 66%

“…LRP is a challenging technique because of its lengthy learning curve, ergonomics associated with instrumentation, and the requirement for expertise in laparoscopic surgery [10]. RARP is more attractive to many surgeons compared to LRP as a result of the more rapid transfer of open-surgery skills to a minimallyinvasive setting, three-dimensional vision, six degrees of freedom, downscaling of movements and elimination of physiological tremor [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

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1003 Impact of Surgical Technique (Open vs. Laparoscopic vs. Robotic-Assisted) on Pathological and Biochemical Outcomes Following Radical Prostatectomy: An Analysis Using Propensity Score Matching

Magheli¹,

Gonzalgo²,

Su³

et al. 2011

European Urology Supplements

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

1003 Impact of Surgical Technique (Open vs. Laparoscopic vs. Robotic-Assisted) on Pathological and Biochemical Outcomes Following Radical Prostatectomy: An Analysis Using Propensity Score Matching

Magheli¹,

Gonzalgo²,

Su³

et al. 2011

European Urology Supplements

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“…At the University of California Irvine, the shortand long-term benefits of procedure-specific 5-day robotic surgery training courses have been reported. 14,15 More recently, educators at the University of Texas Southwestern have published feasibility, validity, and reliability data on a competency-based inanimate training program for robotic surgery, which also addresses the need for structured training programs. 16 Surgical training literature has clearly demonstrated the superior educational outcomes associated with curricula that adhere to the principles of spaced-learning and competency-based training.…”

Section: Discussionmentioning

confidence: 99%

Robotic surgery basic skills training: Evaluation of a pilot multidisciplinary simulation-based curriculum

Foell

Finelli

Yasufuku

et al. 2013

CUAJ

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Purpose: Simulation-based training improves clinical skills, while minimizing the impact of the educational process on patient care. We present results of a pilot multidisciplinary, simulation-based robotic surgery basic skills training curriculum (BSTC) for robotic novices. Methods: A 4-week, simulation-based, robotic surgery BSTC was offered to the Departments of Surgery and Obstetrics & Gynecology (ObGyn) at the University of Toronto. The course consisted of various instructional strategies: didactic lecture, self-directed onlinetraining modules, introductory hands-on training with the da Vinci robot (dVR) (Intuitive Surgical Inc., Sunnyvale, CA), and dedicated training on the da Vinci Skills Simulator (Intuitive Surgical Inc., Sunnyvale, CA) (dVSS). A third of trainees participated in competency-based dVSS training, all others engaged in traditional timebased training. Pre-and post-course skill testing was conducted on the dVR using 2 standardized skill tasks: ring transfer (RT) and needle passing (NP). Retention of skills was assessed at 5 months post-BSTC. Results: A total of 37 participants completed training. The mean task completion time and number of errors improved significantly post-course on both RT (180.6 vs. 107.4 sec, p < 0.01 and 3.5 vs. 1.3 sec, p < 0.01, respectively) and NP (197.1 vs. 154.1 sec, p < 0.01 and 4.5 vs. 1.8 sec, p = 0.04, respectively) tasks. No significant difference in performance was seen between specialties. Competency-based training was associated with significantly better post-course performance. The dVSS demonstrated excellent face validity. Conclusions: The implementation of a pilot multidisciplinary, simulation-based robotic surgery BSTC revealed significantly improved basic robotic skills among novice trainees, regardless of specialty or level of training. Competency-based training was associated with significantly better acquisition of basic robotic skills.

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“…Already in 2001, Chitwood et al [24] proposed a similar curriculum, wildly used by others centers with success. Mini-fellowships of 1 week or more were reported as well [16,17]. After a mini-residency program of 5 days, McDougall et al [17] reported 95 % of participants practicing robotic prostatectomy, and even to maintain this procedure in clinical practice in the long-term [16].…”

Section: Discussionmentioning

confidence: 99%

Impact of robotic general surgery course on participants’ surgical practice

et al. 2013

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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...

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Long-Term Impact of a Robot Assisted Laparoscopic Prostatectomy Mini Fellowship Training Program on Postgraduate Urological Practice Patterns

Abstract: An intensive, dedicated 5-day educational course focused on learning robot assisted laparoscopic prostatectomy enabled most participants to successfully incorporate and maintain this procedure in clinical practice in the short term and long term.

Cited by 50 publications

References 18 publications

1003 Impact of Surgical Technique (Open vs. Laparoscopic vs. Robotic-Assisted) on Pathological and Biochemical Outcomes Following Radical Prostatectomy: An Analysis Using Propensity Score Matching

1003 Impact of Surgical Technique (Open vs. Laparoscopic vs. Robotic-Assisted) on Pathological and Biochemical Outcomes Following Radical Prostatectomy: An Analysis Using Propensity Score Matching

Robotic surgery basic skills training: Evaluation of a pilot multidisciplinary simulation-based curriculum

Impact of robotic general surgery course on participants’ surgical practice

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