Training the next generation of surgeons in robotic surgery

Abstract

Context: Robotic surgery has been used with rapidly increasing frequency within urology and across many other surgical specialties. A standardized curriculum for the training and credentialing of robotic surgeons has unfortunately trailed far behind the adoption of this surgical technology.

Objective: To review the current available surgical skills training models, assessments, and curricula for the purpose of training resident, fellow, and practicing surgeons in an effort to promote surgical skill proficiency and mastery and to minimize the risk of patient harm.

Evidence acquisition: We performed a thorough review of available literature through a PubMed database search in February 2015.

Evidence synthesis: In this article, we compiled and scrutinized the available relevant literature regarding past and present robotic surgical training techniques and credentialing criteria. This review details the basic surgical skills (both technical and nontechnical) that are necessary for individuals and teams to be successful in the operative setting. We go on to discuss the role of current robotic surgical training techniques including dry lab and virtual simulators. Finally, we offer current validated training curricula, the Global Evaluative Assessment of Robotic Skills and Fundamentals of Robotic Surgery models, which have laid the groundwork for a future standardized model that could be applied on a national and international level and across several surgical subspecialties. The ultimate goal of the review is to provide a foundation from which a future standardized training and credentialing curriculum could be based.

Conclusion: There is currently a great need for a standardized curriculum to be developed and employed for the use of training and credentialing future and current robotic surgeons.

Keywords: robotic simulation; robotic surgery; robotic training curriculum.

Figure 1

da Vinci surgical systems installed in the US, 1999–2010. Note: Reproduced from Ahmed K, Abboudi H, Guru KA, Khan MS, Dasgupta P. Robotic surgical technology is here to stay and evolve. Trends Urol Men’s Health 2013;4(2):32–36.

Figure 2

Fundamentals of Robotic Surgery dome device. Image courtesy of Roger Smith, PhD. Chief Technology Office at Nicholson Center in Florida Hospital, Celebration, FL, USA.