Abstract
Robotic urological surgery (RUS) has undergone an exponential growth in the last decade and robotic-assisted radical prostatectomy (RARP) is now the most commonly performed robotic procedure. Although guidelines for the safe initiation of this technology are an overwhelming necessity, no standardized credentialing system currently exists to assess competency and safety of the RUS surgeon. An absence of an established training and credentialing protocol for RUS can result in unnecessary complications – both surgical and medicolegal. Above all, it can potentially compromise the safety of the patient undergoing the surgical procedure. Various educational formats including residency, fellowship, “mini-residency,” proctoring, teleproctoring, preceptoring, and simulation can provide the requisite training and evaluation for robotic urological surgeons. However, the need of the hour is the establishment of a central credentialing authority that supervises these educational endeavors and lays down the framework for common guidelines for the safe initiation of a robotic program in any institution.
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Binder J, Kramer W. Robotically-assisted laparoscopic radical prostatectomy. BJU Int. 2001;87:408-410.
Pasticier G, Rietbergen JB, Guillonneau B, Fromont G, Menon M, Vallancien G. Robotically assisted laparoscopic radical prostatectomy: feasibility study in men. Eur Urol. 2001;40:70-74.
Menon M, Tewari A, Peabody J. Vattikuti Institute prostatectomy: technique. J Urol. 2003;169:2289-2292.
Intuitive Surgical web site. www.intuitivesurgical.com. Accessed August 15, 2009.
Steinberg PL, Merguerian PA, Bihrle W III, Seigne JD. The cost of learning robotic-assisted prostatectomy. Urology. 2008;72:1068-1072.
Badani KK, Kaul S, Menon M. Evolution of robotic radical prostatectomy: assessment after 2766 procedures. Cancer. 2007;110:1951-1958.
Hermann TR, Rabenalt R, Stolzenburg JJ, et al. Oncological and functional results of open, robot-assisted and laparoscopic radical prostatectomy: does surgical approach and surgical experience matter? World J Urol. 2007;25:149-160.
Boris RS, Kaul SA, Sarle RC, Stricker HJ. Radical prostatectomy: a single surgeon comparison of retropubic, perineal, and robotic approaches. Can J Urol. 2007;14:3566-3570.
Patel VR, Thaly R, Shah K. Robotic radical prostatectomy: outcomes of 500 cases. BJU Int. 2007;99:1109-1112.
Atug F, Castle EP, Srivastav SK, Burgess SV, Thomas R, Davis R. Positive margins in robotic-assisted radical prostatectomy: impact of learning curve on oncologic outcomes. Eur Urol. 2006;49:866-871.
Ahlering TE, Eichel L, Edwards RA, Lee DI, Skarecky DW. Robotic radical prostatectomy: a technique to reduce pT2 positive margins. Urology. 2004;64:1224-1228.
Zorn KC, Orvieto MA, Gong EM, et al. Robotic radical prostatectomy learning curve of a fellowship – trained laparoscopic surgeon. J Endourol. 2007;21:441-447.
Vickers AJ, Bianco FJ, Serio AM, et al. The surgical learning curve for prostate cancer control after radical prostatectomy. J Natl Cancer Inst. 2007;99:1171-1177.
Vickers AJ, Bianco FJ, Gonen M, et al. Excellent rates of cancer control for patients with organ-confined disease treated by the most experienced surgeons suggest that the primary reason such patients recur is inadequate surgical technique. Eur Urol. 2008;53:960-966.
Zorn KC, Wille MA, Thong AE, et al. Continued Improvement of perioperative, pathological and continence outcomes during 700 robot assisted radical prostatectomies. Can J Urol. 2009;16:4742-4749.
Wilt TJ, Shamliyan TA, Taylor BC, MacDonald R, Kane RL. Association between hospital and surgeon radical prostatectomy volume and patient outcomes: a systematic review. J Urol. 2008;180:820-829.
Nuttall M, Van der Meulen J, Phillips N, et al. A systematic review and critique of the literature relating hospital or surgeon volume to health outcomes for 3 urological cancer procedures. J Urol. 2004;172:2145-2152.
Duchene DA, Moinzadeh A, Gill IS, Clayman RV, Winfield HN. Survey of residency training in laparoscopic and robotic surgery. J Urol. 2006;176:2158-2166.
Rashid HH, Leung YY, Rashid MJ, Oleyourryk G, Valvo JR, Eichel L. Robotic surgical education: a systematic approach to training urology residents to perform robotic-assisted laparoscopic radical prostatectomy. Urology. 2006;68:75-79.
Yap SA, Ellison LM, Low RK. Current laparoscopy training in urology: a comparison of fellowships governed by the Society of Urologic Oncology and the Endourological Society. J Endourol. 2008;22:1755-1760.
Gautam G. The current three-year postgraduate program in urology is insufficient to train a urologist. Indian J Urol. 2008;24:336-338.
Guzzo TJ, Gonzalgo ML. Robotic surgical training of the urologic oncologist. Urol Oncol. 2009;27:214-217.
Schroeck FR, de Sousa CA, Kalman RA, et al. Trainees do not negatively impact the institutional learning curve for robotic prostatectomy as characterized by operative time, estimated blood loss, and positive surgical margin rate. Urology. 2008;71:597-601.
McDougall EM, Corica FA, Chou DS, et al. Short-term impact of a robot-assisted laparoscopic prostatectomy “mini-residency” experience on postgraduate urologists’ practice patterns. Int J Med Robot. 2006;2:70-74.
Gamboa AJ, Santos RT, Sargent ER, et al. Long-term impact of a robot assisted laparoscopic prostatectomy mini fellowship training program on postgraduate urological practice patterns. J Urol. 2009;181:778-782.
Wignall GR, Denstedt JD, Preminger GM, et al. Surgical simulation: a urological perspective. J Urol. 2008;179:1690-1699.
Satava RM. Accomplishments and challenges of surgical simulation. Surg Endosc. 2001;15:232-241.
Matsumoto ED, Hamstra SJ, Radomski SB, Cusimano MD. The effect of bench model fidelity on endourological skills: a randomized controlled study. J Urol. 2002;167:1243-1247.
Grober ED, Hamstra SJ, Wanzel KR, et al. The educational impact of bench model fidelity on the acquisition of technical skill: the use of clinically relevant outcome measures. Ann Surg. 2004;240:374-381.
Kenney PA, Wszolek MF, Gould JJ, Libertino JA, Moinzadeh A. Face, content, and construct validity of dV-trainer, a novel virtual reality simulator for robotic surgery. Urology. 2009;73:1288-1292.
Sachdeva AK, Russell TR. Safe introduction of new procedures and emerging technologies in surgery: education, credentialing and privileging. Surg Clin N Am. 2007;87:853-866.
Sachdeva AK. Acquiring skills in new procedures and technology: the challenge and the opportunity. Arch Surg. 2005;140:387-389.
Livingston EH, Harwell JD. The medicolegal aspects of proctoring. Am J Surg. 2002;184:26-30.
Sachdeva AK, Blair PG. Enhancing patient safety through educational interventions. In: Manuel BM, Nora PF, eds. Surgical Patient Safety: Essential Information for Surgeons in Today’s Environment. Chicago: American College of Surgeons; 2004: chap 14.
Ellison LM, Pinto PA, Kim F, et al. Telerounding and patient satisfaction after surgery. J Am Coll Surg. 2004;199:523-530.
Ellison LM, Nguyen M, Fabrizio MD, Soh A, Permpongkosol S, Kavoussi LR. Postoperative robotic telerounding: a multicenter randomized assessment of patient outcomes and satisfaction. Arch Surg. 2007;142:1177-1181.
Smith CD, Skandalakis JE. Remote presence proctoring by using a wireless remote-control videoconferencing system. Surg Innov. 2005;12:139-143.
Burgess LPA, Syms MJ, Holtel MR, Birkmire-Peters DP, Johnson RE, Ramsey MJ. Telemedicine: teleproctored endoscopic sinus surgery. Laryngoscope. 2002;112:216-219.
Zorn KC, Gautam G, Shalhav AL, et al. Training, credentialing, proctoring and medicolegal risks of robotic urological surgery: recommendations of the society of urologic robotic surgeons. J Urol. 2009;182:1126-1132.
Sachdeva AK. Invited commentary: educational interventions to address the core competencies in surgery. Surgery. 2004;135:43-47.
Sachdeva AK. Acquisition and maintenance of surgical competence. Semin Vasc Surg. 2002;15:182-190.
Verification by the American College of Surgeons for the use of emerging technologies. Bull Am Coll Surg. 1998;83:34-40.
American College of Surgeons. Statements on emerging surgical technologies and the evaluation of credentials. Surg Endosc. 1995;9:207-213.
Lee JY, Mucksavage P, Sundaram CP, McDougall EM. Best practices for robotic surgery training and credentialing. J Urol. 2011 Apr;185(4):1191-1197. Epub 2011 Feb 22.
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Gautam, G., DeCastro, G.J., Trinh, QD., Zorn, K. (2011). Training and Credentialing in Robotic Urological Surgery. In: Patel, V. (eds) Robotic Urologic Surgery. Springer, London. https://doi.org/10.1007/978-1-84882-800-1_3
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DOI: https://doi.org/10.1007/978-1-84882-800-1_3
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