Abstract
Purpose
To assess feasibility of a standardized robot-assisted hysterectomy managed by resident and supervised by senior surgeon using dual-console on a 21-step grid (max score = 42) assessing resident autonomy.
Methods
A total of seven patients managed between September 2019 and March 2020 by six residents in gynecology and obstetrics were included. Standardized robot-assisted hysterectomy for endometrial cancer or adenomyosis was performed.
Results
No conversion to laparotomy, no intra- or post-operative incidents were reported. Mean score on the evaluation scale was 29.8 out of 42 (SD = 7.3). Mean operative time was 104 min (SD = 23). Mean average suturing time was, respectively, 335 s (SD = 57 s) and 270 s (SD = 53 s) for the first and the fourth knot. There was a 65 s improvement between the first and the fourth intracorporeal knot (p = 0.043). The perceived workload evaluated with the NASA TLX score showed a low level of stress (Temporal demand = 1.6 /10), and a low level of frustration (Frustration level = 3.6/10). Experience gained during the surgery was felt to be important (Commitment = 8.6/10).
Conclusion
Standardized robot-assisted hysterectomy managed by a resident supervised by a senior surgeon using the dual-console seems feasible. This tool could be useful to assess residents’ surgical skills.
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Acknowledgments
We would like to thank the nurses who helped us to run this program. The authors are grateful to Mrs. Sylvie Gauthier for editing the manuscript.
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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Gauthier Tristan and Klapczynski Clémence designed and directed the project. Margueritte François and Lacorre Aymeline verified the analytical methods. Sallée Camille, Tardieu Antoine, Peschot Clémence, Boutot Manon, Mohand Nadia contributed to sample preparation. All authors discussed the results and contributed to the final manuscript.
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Klapczynski, C., Sallée, C., Tardieu, A. et al. Training for next generation surgeons: a pilot study of robot-assisted hysterectomy managed by resident using dual console. Arch Gynecol Obstet 303, 981–986 (2021). https://doi.org/10.1007/s00404-020-05870-2
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DOI: https://doi.org/10.1007/s00404-020-05870-2