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Impact of robotic single and dual console systems in the training of minimally invasive gynecology surgery (MIGS) fellows

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Abstract

The advantages of dual console use in robotic surgical education have not been described. The aims of this study are to compare fellow console time, surgical steps performed, and surgical takeovers between attending and fellow surgeons using dual versus single console robotic systems. Participants included minimally invasive gynecologic surgery (MIGS) fellows (N = 3) and subspecialty trained gynecologic surgeons (N = 5). Prospective data were obtained on 126 patients (N = 77 single console, N = 49 dual console) undergoing robotic hysterectomy. Variables included demographics, surgical characteristics (fellow, month of fellowship, attending surgeon, concomitant oophorectomy, additional surgical procedures, estimated blood loss, specimen weight), and outcomes (console time, docking time, console time/docking time ratio, total case time, number of surgical steps performed by the fellow, number of surgical takeovers, complications). After controlling for potential confounders, fellows spent a mean of 25.8 min longer (P < 0.001) at the console in dual console operations compared to single. Dual console surgeries had a greater number of steps performed by the fellow (OR[> 5 steps]: 3.37, P = 0.009), a higher console time/docking time ratio (P < 0.001), and more surgical takeovers between fellow and attending (OR [> 1 takeover]: 3.53, P < 0.001). There were no significant differences between the two groups regarding docking time (P = 0.15), case time (P = 0.79), or complications (P = 0.30). Our findings suggest dual console robotic training provide fellows the opportunity for more “hands-on” experience with longer console time, higher number of surgical steps performed, and added interaction with the attending surgeon when compared with single console training. These surgical metrics provide objectivity in competency-based robotic training without increasing the complications or surgical time.

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Funding

This project was a recipient of the Education Science Career Development Award (ESCDA) Scholars Program- 2021 Endowment for Education Research Award (EERA)- Mayo Clinic, a $10,000 grant that funded the research staff and statistics. This project was presented at the AAGL 49th Virtual Global Congress on MIGS, November 6–14, 2020.

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Authors and Affiliations

  1. McGovern Medical School at The University of Texas Health Science Center at Houston, 6410 Fannin St # 1014, Houston, TX, 77030, USA

    Mateo G. Leon

  2. Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, FL, USA

    Aakriti R. Carrubba, Christopher C. DeStephano & Tri A. Dinh

  3. Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, FL, USA

    Michael G. Heckman & Emily C. Craver

Authors
  1. Mateo G. Leon
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  2. Aakriti R. Carrubba
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  3. Christopher C. DeStephano
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  4. Michael G. Heckman
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  5. Emily C. Craver
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  6. Tri A. Dinh
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by all authors. The first draft of the manuscript was written by MGL, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Mateo G. Leon.

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The authors declare that there are no conflicts of interest.

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The study was reviewed by the Mayo Clinic Institutional Review Board and considered exempt.

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Patients’ written informed consent was not required for this quality improvement analysis.

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Leon, M.G., Carrubba, A.R., DeStephano, C.C. et al. Impact of robotic single and dual console systems in the training of minimally invasive gynecology surgery (MIGS) fellows. J Robotic Surg 16, 1273–1280 (2022). https://doi.org/10.1007/s11701-022-01369-x

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  • DOI: https://doi.org/10.1007/s11701-022-01369-x

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