Parallel, component training in robotic total mesorectal excision.
Rectal cancer
Robotic surgery training
Journal
Journal of robotic surgery
ISSN: 1863-2491
Titre abrégé: J Robot Surg
Pays: England
ID NLM: 101300401
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
received:
16
04
2022
accepted:
14
11
2022
medline:
26
5
2023
pubmed:
15
12
2022
entrez:
14
12
2022
Statut:
ppublish
Résumé
There has been widespread adoption of robotic total mesorectal excision (TME) for rectal cancer in recent years. There is now increasing interest in training robotic novice surgeons in robotic TME surgery using the principles of component-based learning. The aims of our study were to assess the feasibility of delivering a structured, parallel, component-based, training curriculum to surgical trainees and fellows. A prospective pilot study was undertaken between January 2021 and May 2021. A dedicated robotic training pathway was designed with two trainees trained in parallel per each robotic case based on prior experience, training grade and skill set. Component parts of each operation were allocated by the robotic trainer prior to the start of each case. Robotic proficiency was assessed using the Global Evaluative Assessment of Robotic Skills (GEARS) and the EARCS Global Assessment Score (GAS). Three trainees participated in this pilot study, performing a combined number of 52 TME resections. Key components of all 52 TME operations were performed by the trainees. GEARS scores improved throughout the study, with a mean overall baseline score of 17.3 (95% CI 15.1-1.4) compared to an overall final assessment mean score of 23.8 (95% CI 21.6-25.9), p = 0.003. The GAS component improved incrementally for all trainees at each candidate assessment (p < 0.001). Employing a parallel, component-based approach to training in robotic TME surgery is safe and feasible and can be used to train multiple trainees of differing grades simultaneously, whilst maintaining high-quality clinical outcomes.
Identifiants
pubmed: 36515819
doi: 10.1007/s11701-022-01496-5
pii: 10.1007/s11701-022-01496-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1049-1055Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.
Références
Yeo HL, Isaacs AJ, Abelson JS, Milsom JW, Sedrakyan A (2016) Comparison of open, laparoscopic, and robotic colectomies using a large national database: outcomes and trends related to surgery center volume. Dis Colon Rectum 59(6):535–542
doi: 10.1097/DCR.0000000000000580
pubmed: 27145311
Chung G, Hinoul P, Coplan P, Yoo A (2021) Trends in the diffusion of robotic surgery in prostate, uterus, and colorectal procedures: a retrospective population-based study. J Robot Surg 15(2):275–291
doi: 10.1007/s11701-020-01102-6
pubmed: 32564221
Damle A, Damle RN, Flahive JM, Schlussel AT, Davids JS, Sturrock PR et al (2017) Diffusion of technology: trends in robotic-assisted colorectal surgery. Am J Surg 214(5):820–824
doi: 10.1016/j.amjsurg.2017.03.020
pubmed: 28347491
Miskovic D, Ahmed J, Bissett-Amess R, Gómez Ruiz M, Luca F, Jayne D et al (2019) European consensus on the standardization of robotic total mesorectal excision for rectal cancer. Colorectal Dis 21(3):270–276
doi: 10.1111/codi.14502
pubmed: 30489676
Panteleimonitis S, Popeskou S, Aradaib M, Harper M, Ahmed J, Ahmad M et al (2018) Implementation of robotic rectal surgery training programme: importance of standardisation and structured training. Langenbecks Arch Surg 403(6):749–760
doi: 10.1007/s00423-018-1690-1
pubmed: 29926187
pmcid: 6153605
Disbrow DE, Pannell SM, Shanker BA, Albright J, Wu J, Bastawrous A et al (2018) The effect of formal robotic residency training on the adoption of minimally invasive surgery by young colorectal surgeons. J Surg Educ 75(3):767–778
doi: 10.1016/j.jsurg.2017.09.006
pubmed: 29054345
Bosse HM, Mohr J, Buss B, Krautter M, Weyrich P, Herzog W et al (2015) The benefit of repetitive skills training and frequency of expert feedback in the early acquisition of procedural skills. BMC Med Educ 15:22
doi: 10.1186/s12909-015-0286-5
pubmed: 25889459
pmcid: 4339240
Ericsson KA, Harwell KW (2019) Deliberate practice and proposed limits on the effects of practice on the acquisition of expert performance: why the original definition matters and recommendations for future research. Front Psychol 10:2396
doi: 10.3389/fpsyg.2019.02396
pubmed: 31708836
pmcid: 6824411
Bach C, Miernik A, Schönthaler M (2014) Training in robotics: The learning curve and contemporary concepts in training. Arab J Urol 12(1):58–61
doi: 10.1016/j.aju.2013.10.005
pubmed: 26019925
Dev H, Sharma NL, Dawson SN, Neal DE, Shah N (2012) Detailed analysis of operating time learning curves in robotic prostatectomy by a novice surgeon. BJU Int 109(7):1074–1080
doi: 10.1111/j.1464-410X.2011.10665.x
pubmed: 22035342
Aghazadeh MA, Jayaratna IS, Hung AJ, Pan MM, Desai MM, Gill IS et al (2015) External validation of Global Evaluative Assessment of Robotic Skills (GEARS). Surg Endosc 29(11):3261–3266
doi: 10.1007/s00464-015-4070-8
pubmed: 25609318
Goh AC, Goldfarb DW, Sander JC, Miles BJ, Dunkin BJ (2012) Global evaluative assessment of robotic skills: validation of a clinical assessment tool to measure robotic surgical skills. J Urol 187(1):247–252
doi: 10.1016/j.juro.2011.09.032
pubmed: 22099993
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP et al (2014) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg 12(12):1495–1499
doi: 10.1016/j.ijsu.2014.07.013
Panteleimonitis S, Miskovic D, Bissett-Amess R, Figueiredo N, Turina M, Spinoglio G et al (2020) Short-term clinical outcomes of a European training programme for robotic colorectal surgery. Surg Endosc. https://doi.org/10.1007/s00464-020-08184-1
doi: 10.1007/s00464-020-08184-1
pubmed: 33289055
pmcid: 8599412
Castaldi M, Palmer M, Con J, Abouezzi Z, Latifi R, Bergamaschi R (2021) Robotic-Assisted Surgery Training (RAST) Program: an educational research protocol. Surg Technol Int 38:52–55
pubmed: 33830493
King JC, Zeh HJ, Zureikat AH, Celebrezze J, Holtzman MP, Stang ML et al (2016) Safety in numbers: progressive implementation of a robotics program in an academic surgical oncology practice. Surg Innov 23(4):407–414
doi: 10.1177/1553350616646479
pubmed: 27130645
Egberts JH, Kersebaum JN, Mann B, Aselmann H, Hirschburger M, Graß J et al (2021) Defining benchmarks for robotic-assisted low anterior rectum resection in low-morbid patients: a multicenter analysis. Int J Colorectal Dis 36(9):1945–1953
doi: 10.1007/s00384-021-03988-6
pubmed: 34244856
pmcid: 8346389
Gomez Ruiz M, Tou S, Matzel KE (2019) Setting a benchmark in surgical training - robotic training under the European School of Coloproctology. ESCP Colorectal Dis 21(4):489–490
doi: 10.1111/codi.14592
pubmed: 30788899
Waters PS, Flynn J, Larach JT, Fernando D, Peacock O, Foster JD et al (2021) Fellowship training in robotic colorectal surgery within the current hospital setting: an achievable goal? ANZ J Surg 91(11):2337–2344
doi: 10.1111/ans.16677
pubmed: 33719148
Aghayeva A, Baca B (2020) Robotic sphincter saving rectal cancer surgery: a learning curve analysis. Int J Med Robot 16(4):e2112
doi: 10.1002/rcs.2112
pubmed: 32303116
Lee JM, Yang SY, Han YD, Cho MS, Hur H, Min BS et al (2021) Can better surgical outcomes be obtained in the learning process of robotic rectal cancer surgery? A propensity score-matched comparison between learning phases. Surg Endosc 35(2):770–778
doi: 10.1007/s00464-020-07445-3
pubmed: 32055993
Aradaib M, Neary P, Hafeez A, Kalbassi R, Parvaiz A, O’Riordain D (2019) Safe adoption of robotic colorectal surgery using structured training: early Irish experience. J Robot Surg 13(5):657–662
doi: 10.1007/s11701-018-00911-0
pubmed: 30536134
Shaw DD, Wright M, Taylor L, Bertelson NL, Shashidharan M, Menon P et al (2018) Robotic colorectal surgery learning curve and case complexity. J Laparoendosc Adv Surg Tech A 28(10):1163–1168
doi: 10.1089/lap.2016.0411
pubmed: 29733247
Sánchez R, Rodríguez O, Rosciano J, Vegas L, Bond V, Rojas A et al (2016) Robotic surgery training: construct validity of Global Evaluative Assessment of Robotic Skills (GEARS). J Robot Surg 10(3):227–231
doi: 10.1007/s11701-016-0572-1
pubmed: 27039189
Brown KC, Bhattacharyya KD, Kulason S, Zia A, Jarc A (2020) How to bring surgery to the next level: interpretable skills assessment in robotic-assisted surgery. Visc Med 36(6):463–470
doi: 10.1159/000512437
pubmed: 33447602
pmcid: 7768128