Skip to main content
SpringerLink
Log in

Characterization of the robotic surgery experience in minimally invasive surgery fellowships from 2010 to 2021

  • 2023 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Robotic surgery has experienced exponential growth in the past decade. Few studies have evaluated the impact of robotics within minimally invasive surgery (MIS) fellowship training programs. The purpose of our study was to examine and characterize recent trends in robotic surgery within MIS fellowship training programs.

Methods

De-identified case log data from the Fellowship Council from 2010 to 2021 were evaluated. Percentage of operations performed with robot assistance over time was assessed and compared to the laparoscopic and open experience. Case logs were further stratified by operative category (e.g., bariatric, hernia, foregut), and robotic experience over time was evaluated for each category. Programs were stratified by percent robot use and the experience over time within each quartile was evaluated.

Results

MIS fellowship training programs with a robotic platform increased from 45.1% (51/113) to 90.4% (123/136) over the study period. The percentage of robotic cases increased from 2.0% (1127/56,033) to 23.2% (16,139/69,496) while laparoscopic cases decreased from 80.2% (44,954/56,033) to 65.3% (45,356/69,496). Hernia and colorectal case categories had the largest increase in robot usage [hernia: 0.7% (62/8614) to 38.4% (4661/12,135); colorectal 4.2% (116/2747) to 31.8% (666/2094)]. When stratified by percentage of robot utilization, current (2020–2021) programs in the > 95th percentile performed 21.8% (3523/16,139) of robotic operations and programs in the > 50th percentile performed 90.0% (14,533/16,139) of all robotic cases. The median number of robotic cases performed per MIS fellow significantly increased from 2010 to 2021 [0 (0–6) to 72.5 (17.8–171.5), p < 0.01].

Conclusions

Robotic use in MIS fellowship training programs has grown substantially in the past decade, but the laparoscopic and open experience remains robust. There remains an imbalance with the top 50% of busiest robotic programs performing over 90% of robot trainee cases. The experience in MIS programs varies widely and trainees should examine program case logs closely to confirm parallel interests.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Chen R, Rodrigues Armijo P, Krause C, Siu KC, Oleynikov D (2020) A comprehensive review of robotic surgery curriculum and training for residents, fellows, and postgraduate surgical education. Surg Endosc 34(1):361–367

    Article  PubMed  Google Scholar 

  2. Reinisch A, Liese J, Padberg W, Ulrich F (2022) Robotic operations in urgent general surgery: a systematic review. J Robot Surg. https://doi.org/10.1007/s11701-022-01425-6

    Article  PubMed  PubMed Central  Google Scholar 

  3. Childers CP, Maggard-Gibbons M (2018) Estimation of the acquisition and operating costs for robotic surgery. JAMA 320(8):835–836

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mederos MA, Jacob RL, Ward R, Shenoy R, Gibbons MM, Girgis MD, Kansagara D, Hynes D, Shekelle PG, Kondo K (2022) Trends in robot-assisted procedures for general surgery in the Veterans Health Administration. J Surg Res 279:788–795

    Article  PubMed  Google Scholar 

  5. Rizzo KR, Grasso S, Ford B, Myers A, Ofstun E, Walker A (2022) Status of robotic assisted surgery (RAS) and the effects of coronavirus (COVID-19) on RAS in the Department of Defense (DoD). J Robot Surg. https://doi.org/10.1007/s11701-022-01432-7

    Article  PubMed Central  Google Scholar 

  6. Herron DM, Marohn M (2008) A consensus document on robotic surgery. Surg Endosc 22(2):313–325

    Article  CAS  PubMed  Google Scholar 

  7. Smith R, Patel V, Satava R (2014) Fundamentals of robotic surgery: a course of basic robotic surgery skills based upon a 14-society consensus template of outcomes measures and curriculum development. Int J Med Robot 10(3):379–384

    Article  PubMed  Google Scholar 

  8. Nwaelugo NS, Goldblatt MI, Gould JC, Higgins RM (2022) The evolution of the general surgery resident operative case experience in the era of robotic surgery. Surg Endosc 36(9):6679–6687

    Article  PubMed  Google Scholar 

  9. Mehaffey JH, Michaels AD, Mullen MG, Yount KW, Meneveau MO, Smith PW, Friel CM, Schirmer BD (2017) Adoption of robotics in a general surgery residency program: at what cost? J Surg Res 213:269–273

    Article  Google Scholar 

  10. Farivar BS, Flannagan M, Leitman IM (2015) General surgery residents’ perception of robot-assisted procedures during surgical training. J Surg Educ 72(2):235–242

    Article  Google Scholar 

  11. Watkins JR, Pryor AD, Truitt MS, Jeyarajah DR (2018) Perception versus reality: elucidating motivation and expectations of current fellowship council minimally invasive surgery fellows. Surg Endosc 32(11):4422–4427

    Article  PubMed  Google Scholar 

  12. Weis JJ, Pryor A, Alseidi A, Tellez J, Goldblatt MI, Mattar S, Murayama K, Awad M, Scott DJ (2022) Defining benchmarks for fellowship training in foregut surgery: a 10-year review of fellowship council index cases. Surg Endosc 36(12):8856–8862

    Article  Google Scholar 

  13. Shellito AD, Kapadia S, Kaji AH, Tom CM, Dauphine C, Petrie BA (2022) Current status of robotic surgery in colorectal residency training programs. Surg Endosc 36(1):307–313

    Article  PubMed  Google Scholar 

  14. The Fellowship Council (2023) Advanced GI surgery curriculum for minimally invasive surgery. https://www.fellowshipcouncil.org/wp-content/uploads/2012/02/MIS.pdf. Accessed 24 June 2023

  15. Sheetz KH, Claflin J, Dimick JB (2020) Trends in the adoption of robotic surgery for common surgical procedures. JAMA Netw Open 3(1):e1918911

    Article  PubMed  PubMed Central  Google Scholar 

  16. Bauerle WB, Mody P, Estep A, Stoltzfus J, El Chaar M (2023) Current trends in the utilization of a robotic approach in the field of bariatric surgery. Obes Surg 33(2):482–491

    Article  Google Scholar 

Download references

Acknowledgements

Thank you to the FC research committee for providing access to the case log database.

Funding

None.

Author information

Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, University of Virginia Health, 1215 Lee St., Charlottesville, VA, 22903, USA

    Nathan Haywood, Aimee Zhang, Peter Hallowell & Bruce Schirmer

  2. Department of General Surgery, Sheridan Memorial Hospital, Sheridan, WY, USA

    Joshua Scott

Authors
  1. Nathan Haywood
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joshua Scott
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aimee Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter Hallowell
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bruce Schirmer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Nathan Haywood or Bruce Schirmer.

Ethics declarations

Disclosures

Bruce Schirmer is on the advisory board for Allurion Inc., a company that makes intragastric balloons. There is no direct conflict of interest with this position. Nathan Haywood, Joshua Scott, Aimee Zhang, and Peter Hallowell have no conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 13 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Haywood, N., Scott, J., Zhang, A. et al. Characterization of the robotic surgery experience in minimally invasive surgery fellowships from 2010 to 2021. Surg Endosc 37, 9393–9398 (2023). https://doi.org/10.1007/s00464-023-10402-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-023-10402-5

Keywords

Search

Navigation