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Towards standardized robotic surgery in gastrointestinal oncology

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Abstract

Purpose

Minimally invasive techniques have revolutionized the field of surgery over the past several decades. Specifically, robotic surgery is increasingly being used for complex operations, although the appreciable learning curve required to become proficient has deterred many surgeons. We describe how use of a proficiency-based training program can decrease the learning curve and lead to standardized robotic surgery.

Methods

The steps of a proficiency-based robotic training program are described, including (1) a proficiency-based virtual reality simulation curriculum, (2) an inanimate biotissue curriculum, (3) a video library training, (4) intraoperative evaluation, and (5) skill maintenance with ongoing assessment. The learning curve for robotic gastrointestinal surgery is explored, as well as outcomes compared to laparoscopic and open techniques.

Results

The implementation of a proficiency-based robotic training program is feasible. Surgical oncology fellows who participated in the program demonstrated improvement in both the simulation and biotissue curricula. Analyzed as a group, the participants improved in time and errors after the biotissue curriculum.

Conclusions

Published outcomes from robotic gastrointestinal surgery have demonstrated safety, feasibility, and preserved oncologic resections. A proficiency-based robotic curriculum is ideal to enable surgeons to achieve mastery in robotic surgery while minimizing the learning curve required.

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Authors and Affiliations

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

    Lawrence M. Knab, Amer H. Zureikat, Herbert J. Zeh III & Melissa E. Hogg

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  1. Lawrence M. Knab
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  2. Amer H. Zureikat
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  3. Herbert J. Zeh III
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  4. Melissa E. Hogg
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Correspondence to Lawrence M. Knab.

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Melissa Hogg receives funding from the Veterans’ Affairs in the way of salary support. She also has grants from Intuitive Surgical and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). The other authors have nothing to disclose.

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This article does not contain any studies with human participants performed by any of the authors.

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Knab, L.M., Zureikat, A.H., Zeh, H.J. et al. Towards standardized robotic surgery in gastrointestinal oncology. Langenbecks Arch Surg 402, 1003–1014 (2017). https://doi.org/10.1007/s00423-017-1623-4

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  • DOI: https://doi.org/10.1007/s00423-017-1623-4

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