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Evolution of a Novel Robotic Training Curriculum in a Complex General Surgical Oncology Fellowship

  • Health Services Research and Global Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

A Correction to this article was published on 12 December 2018

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Abstract

Background

Robotic surgery is increasingly being used for complex oncologic operations, although currently there is no standardized curriculum in place for surgical oncologists. We describe the evolution of a proficiency-based robotic training program implemented for surgical oncology fellows, and demonstrate the outcomes of the program.

Methods

A 5-step robotic curriculum began integration in July 2013. Fellows from July 2013 to August 2017 were included. An education portfolio was created for each fellow, including pre-fellowship experience, fellowship experience with data from robotic curriculum and operative experience, and post-fellowship practice information.

Results

Of 30 fellows, 20% completed a prior fellowship, 97% trained at an academic residency, 57% had prior robotic training (median 5 h), and 43% had performed robotic surgery (median 0 cases). In fellowship, on average, fellows spent 5 h on the virtual reality curriculum and performed 19 biotissue anastomoses. For total surgeries, fellows operating from the console increased over time (p = 0.005). For pancreas, the average percentage of robotic pancreaticoduodenectomy (PD) steps completed increased (p < 0.011), as did the number of PDs in which the fellow completed the entire resection (p = 0.013). Fellows were 10 times more likely to complete the entire distal than PD from the console (p < 0.01). Post-fellowship, 83% of fellows obtained an academic position, 88% utilized robotics, and 91% performed pancreatic surgery.

Conclusions

With dedicated training, fellows can safely primarily perform complex gastrointestinal robotic surgeries and, after graduation, take jobs incorporating this skill set. In this era of scrutiny on cost and outcomes, specialized training programs offer a safe integration option for complex technical skills.

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Change history

  • 12 December 2018

    In the XML of the original article, L. Mark Knab?s first name was tagged incorrectly.

  • 12 December 2018

    In the XML of the original article, L. Mark Knab���s first name was tagged incorrectly.

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Disclosures

Melissa E. Hogg receives funding from the Veterans Affairs in the way of salary support, and has received grant funding from SAGES and Intuitive Surgical.

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Authors and Affiliations

  1. Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    L. Mark Knab MD, Mazen S. Zenati MD, MPH, PhD, Anton Khodakov BS, Maryjoe Rice BS, Amr Al-abbas MD, David L. Bartlett MD, Amer H. Zureikat MD & Melissa E. Hogg MD, MS

  2. Department of Surgery, University of Texas Southwestern, Dallas, TX, USA

    Herbert J. Zeh MD

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  1. L. Mark Knab MD
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  2. Mazen S. Zenati MD, MPH, PhD
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  3. Anton Khodakov BS
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  9. Melissa E. Hogg MD, MS
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Correspondence to Melissa E. Hogg MD, MS.

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Mark Knab, L., Zenati, M.S., Khodakov, A. et al. Evolution of a Novel Robotic Training Curriculum in a Complex General Surgical Oncology Fellowship. Ann Surg Oncol 25, 3445–3452 (2018). https://doi.org/10.1245/s10434-018-6686-0

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