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General surgery training in the era of robotic surgery: a qualitative analysis of perceptions from resident and attending surgeons

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Abstract

Background

The use of the surgical robot has increased annually since its introduction, especially in general surgery. Despite the tremendous increase in utilization, there are currently no validated curricula to train residents in robotic surgery, and the effects of robotic surgery on general surgery residency training are not well defined. In this study, we aim to explore the perceptions of resident and attending surgeons toward robotic surgery education in general surgery residency training.

Methods

We performed a qualitative thematic analysis of in-person, one-on-one, semi-structured interviews with general surgery residents and attending surgeons at a large academic health system. Convenient and purposeful sampling was performed in order to ensure diverse demographics, experiences, and opinions were represented. Data were analyzed continuously, and interviews were conducted until thematic saturation was reached, which occurred after 20 residents and seven attendings.

Results

All interviewees agreed that dual consoles are necessary to maximize the teaching potential of the robotic platform, and the importance of simulation and simulators in robotic surgery education is paramount. However, further work to ensure proper access to simulation resources for residents is necessary. While most recognize that bedside-assist skills are essential, most think its educational value plateaus quickly. Lastly, residents believe that earlier exposure to robotic surgery is necessary and that almost every case has a portion that is level-appropriate for residents to perform on the robot.

Conclusions

As robotic surgery transitions from novelty to ubiquity, the importance of effective general surgery robotic surgery training during residency is paramount. Through in-depth interviews, this study provides examples of effective educational tools and techniques, highlights the importance of simulation, and explores opinions regarding the role of the resident in robotic surgery education. We hope the insights gained from this study can be used to develop and/or refine robotic surgery curricula.

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Acknowledgements

Dr. Zhao was supported by the National Library of Medicine Training Grant [NIH Grant: T15LM011271]. The funding source had no role in the design and/or general conduct of this study; had no access to the data or role in data collection, management, analysis, or interpretation; had no role in the preparation, review, or approval of the manuscript; and had no role in the decision to submit the manuscript for publication.

Funding

Dr. Beiqun Zhao was supported by the National Library of Medicine Training Grant [NIH Grant: T15LM011271].

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Authors and Affiliations

  1. Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA

    Beiqun Zhao, Jenny Lam, Hannah M. Hollandsworth, Arielle M. Lee, Nicole E. Lopez, Benjamin Abbadessa, Samuel Eisenstein, Bard C. Cosman, Sonia L. Ramamoorthy & Lisa A. Parry

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  1. Beiqun Zhao
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Correspondence to Beiqun Zhao.

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Jenny Lam, Hannah M. Hollandsworth, Arielle M. Lee, Nicole E. Lopez, Benjamin Abbadessa, Samuel Eisenstein, Bard C. Cosman, Sonia L. Ramamoorthy, and Lisa A. Parry have no conflict of interest or financial ties to disclose.

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Zhao, B., Lam, J., Hollandsworth, H.M. et al. General surgery training in the era of robotic surgery: a qualitative analysis of perceptions from resident and attending surgeons. Surg Endosc 34, 1712–1721 (2020). https://doi.org/10.1007/s00464-019-06954-0

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