Residency Training Program Paradigms for Teaching Robotic Surgical Skills to Urology Residents

Abstract

The advent of laparoscopic and robotic techniques for management of urologic malignancies marked the beginning of an ever-expanding array of minimally invasive options available to cancer patients. With the popularity of these treatment modalities, there is a growing need for trained surgical oncologists who not only have a deep understanding of the disease process and adept surgical skills, but also show technical mastery in operating the equipment used to perform these techniques. Establishing a robotic prostatectomy program is a tremendous undertaking for any institution, as it involves a huge cost, especially in the purchasing and maintenance of the robot. Residency programs often face many challenges when trying to establish a balance between costs associated with robotic surgery and training of the urology residents, while maintaining an acceptable operative time. Herein we describe residency training program paradigms for teaching robotic surgical skills to urology residents. Our proposed paradigm outlines the approach to compensate for the cost involved in robotic training establishment without compromising the quality of education provided. With the potential advantages for both patients and surgeons, we contemplate that robotic-assisted surgery may become an integral component of residency training programs in the future.

Robot-assisted radical prostatectomy: a case series of the first 100 patients -constitutional introduction and implementation on the basis of comprehensive department of minimal invasive surgery center-

“…The complication rate according to Clavien classification of our study is comparable with that of a previous study of 200 initial cases reported by Jeong et al; however, the rate of severe complications other than Clavien I was much less in our study when compared with that report [17]. The structured program for the certification of console surgeons in the MISC and our original step-by-step training program referenced by a previous study [18] has been suggested to minimize the severe complications and the requirement of open conversion operations. 2) BCR and PSM rate: Because the follow-up duration is relatively short in our patient cohort, oncological control was only been evaluated by PSM rate to date.…”

Lessons learned: end‐user assessment of a skills laboratory based training programme for urology trainees

“…As theoretical and technological advances continue to push the boundaries of what constitutes general urology training, residency programmes must continue to adapt both their curriculum content and delivery of content to address potential shortfalls [6]. One response to this challenge could be the introduction of subspecialist training early into the residency programme, such that more nuanced proficiency in open, robotic/laparoscopic or endoscopic urology can be developed by the completion of mandated training.…”

Robotic Surgery

“…12 Heightened expectations from patients and medico-legal implications, as well as demands from hospital administrators to maximize results, mean that there is a limited opportunity for residents to train with the system. 13 Even more significant is the lack of any standardized competence-based training curriculum, which has been consistently underlined in successive literature. 14,15 the new training curriculum Guzzo et al and Shah et al proposed three essential phases in a structured robotics training program: preclinical phase, bedside assistant phase and operative console phase.…”