Utilising an Accelerated Delphi Process to Develop Guidance and Protocols for Telepresence Applications in Remote Robotic Surgery Training

Abstract

Context The role of robot-assisted surgery continues to expand at a time when trainers and proctors have travel restrictions during the coronavirus disease 2019 (COVID-19) pandemic. Objective To provide guidance on setting up and running an optimised telementoring service that can be integrated into current validated curricula. We define a standardised approach to training candidates in skill acquisition via telepresence technologies. We aim to describe an approach based on the current evidence and available technologies, and define the key elements within optimised telepresence services, by seeking consensus from an expert committee comprising key opinion leaders in training. Evidence acquisition This project was carried out in phases: a systematic review of the current literature, a teleconference meeting, and then an initial survey were conducted based on the current evidence and expert opinion, and sent to the committee. Twenty-four experts in training, including clinicians, academics, and industry, contributed to the Delphi process. An accelerated Delphi process underwent three rounds and was completed within 72 h. Additions to the second- and third-round surveys were formulated based on the answers and comments from the previous rounds. Consensus opinion was defined as ≥80% agreement. Evidence synthesis There was 100% consensus regarding an urgent need for international agreement on guidance for optimised telepresence. Consensus was reached in multiple areas, including (1) infrastructure and functionality; (2) definitions and terminology; (3) protocols for training, communication, and safety issues; and (4) accountability including ethical and legal issues. The resulting formulated guidance showed good internal consistency among experts, with a Cronbach alpha of 0.90. Conclusions Using the Delphi methodology, we achieved international consensus among experts for development and content validation of optimised telepresence services for robotic surgery training. This guidance lays the foundation for launching telepresence services in robotic surgery. This guidance will require further validation. Patient summary Owing to travel restrictions during the coronavirus disease 2019 (COVID-19) pandemic, development of remote training and support via telemedicine is becoming increasingly important. We report a key opinion leader consensus view on a standardised approach to telepresence.

Ethical implications of AI in robotic surgical training: A Delphi consensus statement

“…In robotic surgical training this can be achieved with standardised robotic curricula, train-the-trainer courses and agreed protocols that define surgical training at a granular level that can be aligned with telemetry data and more easily interpreted in computer vision analysis [7,10,21,22]. Further adoption of the performance metrics for identified key index procedures will be enabled by familiar definitions, that are open source and culminated together in data registries in established robotic surgery networks [8].…”

Current Trends in Volume and Surgical Outcomes in Gastric Cancer

“…Robotic-assisted gastrectomy might overcome some challenges, by offering improved visualization through 3D images and increased magnification, instrument articulation, superior ergonomics, and tremor filtration. Minimally invasive surgery has been demonstrated to be safe and effective, mainly if performed in referral centers, even if further trials are required to establish the superiority of robotic gastrectomy on long-term outcomes [ 70 ]. On a population level, the introduction of robotics is expected to have contributed to the centralization of cases in an unintended but potentially beneficial way.…”

Master of industrial training 2.0.: Human resources capacity of the project “Professionalitat”

“…Так, например, опыт кардинального обновления содержания профессионального образования за счет внедрения цифровых инноваций, междисциплинарной командной и системной работы в сферу клинической микробиологии и инфекционных заболеваний был представлен K. Last, N. R. Power, S. Dellière и др. [50], а первые успехи в обеспечении дистанционного присутствия при обучении удаленной роботизированной хирургии освещены J. W. Collins, A. Ghazi, D. Stoyanov [51].…”