Robotic lobectomy can be taught while maintaining quality patient outcomes

Abstract

Robotic lobectomy can be safely taught to residents without compromising patient outcomes by dividing it into a series of surgical maneuvers. Recording outcomes for each step and using video review and coaching techniques may help increase the percent of maneuvers residents can complete in a set time.

Tips and tricks to decrease the duration of operation in robotic surgery for lung cancer

“…Since 2010, the year of our first robotic lobectomy, we have developed and refined systematic procedures that optimize patient outcomes while enabling an environment conducive to teaching residents (14). These robotic lobectomy techniques have been arranged as a series of major chronologic steps, defined for each of the five different types of lobectomy, as seen in Table 1 (14). These steps are identified repeatedly before and during operations, allowing every team membernurses, anesthesiologists, students, and residents-to be aware of both what is happening and what will happen next.…”

“…We have done just that: Table 1 delineates both the steps to our procedures as well as their respective desired durations (14). These assigned durations were derived from our previous experience as well as videos of other surgeons' robotic operations (14).…”

“…We have done just that: Table 1 delineates both the steps to our procedures as well as their respective desired durations (14). These assigned durations were derived from our previous experience as well as videos of other surgeons' robotic operations (14). When adhering to this methodology, operative time can be efficiently but safely minimized and should be under two hours (14).…”

“…These assigned durations were derived from our previous experience as well as videos of other surgeons' robotic operations (14). When adhering to this methodology, operative time can be efficiently but safely minimized and should be under two hours (14). The practice of assessing and analyzing the duration of each step provides twofold benefits.…”

“…Compounding this, cost estimations peg an additional minute of operating room time between $22 and $133 in the United States (12). In addition, long operative times can make it more difficult from practicality and safety standpoints to teach robotic surgery to residents at academic medical centers, and surgeons not confident in their robotic operative technique cannot adequately or responsibly serve as mentors for their trainees (13,14). Nevertheless, these hurdles are neither inherent nor inevitable drawbacks.…”