Clin Colon Rectal Surg 2021; 34(05): 280-285
DOI: 10.1055/s-0041-1729861
Review Article

Teaching and Training Surgeons in Robotic Colorectal Surgery

Mark K. Soliman
1   Department of Colorectal Surgery, Advent Health Digestive Health and Surgery Institute, Orlando, Florida
,
Alison J. Tammany
1   Department of Colorectal Surgery, Advent Health Digestive Health and Surgery Institute, Orlando, Florida
› Author Affiliations

Abstract

Robotic surgery is becoming more popular among practicing physicians as a new modality with improved visualization and mobility (1–2). As patients also desire minimally invasive procedures with quicker recoveries, there is a desire for new surgical residents and fellows to pursue robotic techniques in training (3–4). To develop a new colorectal robotics training program, an institution needs a well-formulated plan for the trainees and mentors with realistic expectations. The development of a robotics training program has potential obstacles, including increased initial cost, longer operative times, and overcoming learning curves. We have devised a four-phase training protocol for residents in colorectal surgical fellowship. Each of these phases attempts to create a curricular framework that outlines logical progression and sets expectations for trainees, Program Directors, and residency faculty. Phase zero begins prior to fellowship and is preparatory. Phase one focuses on an introduction to robotics with learning bedside console troubleshooting and simulation exercises. Phase Two prioritizes operative experience and safety while completing steps independently in a progressive fashion. Phase Three polishes the resident prior to graduation for future practice. We recommend frequent evaluation and open-mindedness while establishing a focused robotics program. The end goal is to graduate fellows with an equivalency certificate who can continue to practice colorectal robotic surgery.



Publication History

Article published online:
03 September 2021

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  • References

  • 1 deSouza AL, Prasad LM, Park JJ, Marecik SJ, Blumetti J, Abcarian H. Robotic assistance in right hemicolectomy: is there a role?. Dis Colon Rectum 2010; 53 (07) 1000-1006
  • 2 Mushtaq HH, Shah SK, Agarwal AK. The current role of robotics in colorectal surgery. Curr Gastroenterol Rep 2019; 21 (03) 11
  • 3 Keller DS, Zaghiyan K, Mizell JS. Use of robotic technology: a survey of practice patterns of the ASCRS Young Surgeons Committee. Tech Coloproctol 2018; 22 (09) 715-717
  • 4 Saraidaridis JT, Read TE, Marcello PW. et al. What do young colorectal surgeons value from their CRS residency training?. J Surg Educ 2019; 76 (03) 720-726
  • 5 Center for Devices and Radiological Health. Computer-Assisted Surgical Systems. U.S. Food and Drug Administration; . 2019, March 13. Available March 28, 2020 at: https://www.fda.gov/medical-devices/surgery-devices/computer-assisted-surgical-systems
  • 6 Weber PA, Merola S, Wasielewski A, Ballantyne GH. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum 2002; 45 (12) 1689-1694 , discussion 1695–1696
  • 7 Cera SM. Hybrid robotic and fully robotic procedures. In: Wexner SD, Fleshman J. eds. Colon And Rectal Surgery: Abdominal Operations. Philadelphia, PA: Wolters Kluwer; 2011. 167-179
  • 8 Bolger JC, Broe MP, Zarog MA. et al. Initial experience with a dual-console robotic-assisted platform for training in colorectal surgery. Tech Coloproctol 2017; 21 (09) 721-727
  • 9 Prasad LM. Robotic left colon and rectal resection. In: Wexner SD, Fleshman J. eds. Colon And Rectal Surgery: Abdominal Operations. Philadelphia, PA: Wolters Kluwer; 2011: 89-114
  • 10 Aradaib M, Neary P, Hafeez A, Kalbassi R, Parvaiz A, O'Riordain D. Safe adoption of robotic colorectal surgery using structured training: early Irish experience. J Robot Surg 2019; 13 (05) 657-662
  • 11 Akmal Y, Baek JH, McKenzie S, Garcia-Aguilar J, Pigazzi A. Robot-assisted total mesorectal excision: is there a learning curve?. Surg Endosc 2012; 26 (09) 2471-2476
  • 12 Fleming CA, Westby D, Ullah MF. et al. A review of clinical and oncological outcomes following the introduction of the first robotic colorectal surgery programme to a university teaching hospital in Ireland using a dual console training program. J Robot Surg 2020; 14 (06) 889-896
  • 13 Major P, Wysocki M, Dworak J, Pędziwiatr M, Małczak P, Budzyński A. Are bariatric operations performed by residents safe and efficient?. Surg Obes Relat Dis 2017; 13 (04) 614-621
  • 14 Kiran RP, Ahmed Ali U, Coffey JC, Vogel JD, Pokala N, Fazio VW. Impact of resident participation in surgical operations on postoperative outcomes: National Surgical Quality Improvement Program. Ann Surg 2012; 256 (03) 469-475
  • 15 Jiménez-Rodríguez RM, Rubio-Dorado-Manzanares M, Díaz-Pavón JM. et al. Learning curve in robotic rectal cancer surgery: current state of affairs. Int J Colorectal Dis 2016; 31 (12) 1807-1815
  • 16 Guend H, Widmar M, Patel S. et al. Developing a robotic colorectal cancer surgery program: understanding institutional and individual learning curves. Surg Endosc 2017; 31 (07) 2820-2828
  • 17 Bosker R, Groen H, Hoff C, Totte E, Ploeg R, Pierie JP. Early learning effect of residents for laparoscopic sigmoid resection. J Surg Educ 2013; 70 (02) 200-205
  • 18 Kim YW, Lee HM, Kim NK, Min BS, Lee KY. The learning curve for robot-assisted total mesorectal excision for rectal cancer. Surg Laparosc Endosc Percutan Tech 2012; 22 (05) 400-405
  • 19 Bokhari MB, Patel CB, Ramos-Valadez DI, Ragupathi M, Haas EM. Learning curve for robotic-assisted laparoscopic colorectal surgery. Surg Endosc 2011; 25 (03) 855-860
  • 20 Niitsu H, Hirabayashi N, Yoshimitsu M. et al. Using the Objective Structured Assessment of Technical Skills (OSATS) global rating scale to evaluate the skills of surgical trainees in the operating room. Surg Today 2013; 43 (03) 271-275
  • 21 Moit H, Dwyer A, De Sutter M, Heinzel S, Crawford D. A standardized robotic training curriculum in a General Surgery Program. JSLS 2019; 23 (04) e2019.00045
  • 22 Sánchez R, Rodríguez O, Rosciano J. et al. Robotic surgery training: construct validity of Global Evaluative Assessment of Robotic Skills (GEARS). J Robot Surg 2016; 10 (03) 227-231
  • 23 Goh AC, Goldfarb DW, Sander JC, Miles BJ, Dunkin BJ. Global evaluative assessment of robotic skills: validation of a clinical assessment tool to measure robotic surgical skills. J Urol 2012; 187 (01) 247-252
  • 24 Martin R, Hsu J, Soliman MK, Bastawrous AL, Cleary RK. Incorporating a detailed case log system to standardize robotic colon and rectal surgery resident training and performance evaluation. J Surg Educ 2019; 76 (04) 1022-1029