Instruments and TechniquesRobotic Surgical Training Program in Gynecology: How to Train Residents and Fellows
Section snippets
Materials and Methods
Through the Computer and Robotic Enhanced Surgery (CARES) Center at the University of North Carolina at Chapel Hill (UNC-CH), a training curriculum was established to standardize both orientation to and surgical training using the da Vinci Surgical System (Intuitive, Inc., Sunnyvale, CA) for resident and fellow trainees in the Department of Obstetrics and Gynecology. All third- and fourth-year residents in the Department of Obstetrics and Gynecology and first-year fellows in the gynecologic
Results
All 7 third-year residents, all 6 fourth-year residents, and all 4 first-year gynecology fellows completed the 3 phases of the training protocol: the Online Training Module, the Docking Practicum, and the Surgical Skills Practicum. The online training module was a prerequisite to completing the Docking and Surgical Skills Practica. In assessing baseline aptitude, pass rates varied widely for each drill. The docking drill had the highest pass rate at 100%, followed by dissection and then
Discussion
Resident and fellow training in new surgical technology is an important part of a medical education curriculum. As new MIS technologies are introduced, clinical training must be adapted to meet these needs. Herein is described one method to accomplish robotic training that standardizes both instruction in and assessment of robotic surgical skills. An objective training protocol is important not only to instruct residents and fellows in robotic surgery but also for their credentialing in robotic
References (13)
- et al.
Robotics and ergonomics
Surg Clin North Am
(2003) - et al.
A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy
Am J Obstet Gynecol
(2008) - et al.
The financial impact of teaching surgical residents in the operating room
Am J Surg
(1999) - et al.
Surgical outcomes of robotic-assisted surgical staging for endometrial cancer are equivalent to traditional laparoscopic staging at a minimally invasive surgical center
Gynecol Oncol
(2010) - et al.
Comparison of robotic and laparoscopic myomectomy
Am J Obstet Gynecol
(2009) - et al.
Surgical approach to hysterectomy for benign gynaecological disease
Cochrane Database Syst Rev
(2009)
Cited by (32)
Robotic surgical training: Where are we?
2016, Gynecologic OncologyCitation Excerpt :As a result, the need for a formal robotic training curriculum for gynecologic oncologists has never been greater. In 2011, Geller et al. published the results of a gynecologic-specific training program developed at the Computer and Robotic Enhanced Surgery center of the University of North Carolina, Chappell Hill (UNC) [27]. The program included third- and fourth-year residents and first-year fellows in all gynecologic subspecialties, although there was a major focus on gynecologic oncology.
Fellowship learning curve associated with completing a robotic assisted total laparoscopic hysterectomy
2014, Gynecologic OncologyCitation Excerpt :Residency and fellowship training programs have started to incorporate robotic training into their surgical curriculums. A few institutions have proposed skill exercises and protocols for robotic training [4–6]; however, the optimal fashion to integrate robotic surgical training into residency/fellowship programs is yet to be determined. In a recent survey of 21 obstetric and gynecology program directors and 42 graduating residents, 0% of the directors and 2.8% of the residents reported being “completely prepared” to perform a robotic hysterectomy [7].
Virtual reality robotic surgical simulation: An analysis of gynecology trainees
2014, Journal of Surgical EducationSuccessful incorporation of robotic surgery into gynecologic oncology fellowship training
2013, Gynecologic OncologyCitation Excerpt :These statistics emphasize the importance of adequately educating fellows in the use of this new technology. Similar to reports from other institutions, the fellows in our program are required to go through a series of training steps prior to participating in robotic surgical cases [7,13]. First, they must complete the online training module provided by Intuitive Surgery.
Assessment of robotic simulation by trainees in residency programs of the southeastern section of the american urologic association
2013, Journal of Surgical EducationCitation Excerpt :Educators have yet to determine the optimal method of teaching robotic surgery to trainees. Training paradigms have been proposed, but most involve training during live surgery, which carries the risk of patient harm, especially early in the trainee learning curve.7,10,15 Training in this manner is also limited by surgeon availability and time as well as by medical legal risk to the supervising surgeon.
Analysis of Robotic Performance Times to Improve Operative Efficiency
2013, Journal of Minimally Invasive Gynecology
Supported by an “Investments for the Future Grant” from the Computer and Robotic Enhanced Surgery (CARES) Center, University of North Carolina School of Medicine at the University of North Carolina at Chapel Hill.
Dr. Boggess is a consultant for Intuitive Surgical, Inc., Sunnyvale, CA.