Allyne Topaz, MD, Lauren Poliakin, MD, Luca Milone, MD. The Brooklyn Hospital
Background: Previous studies have shown positive outcomes involving dedicated resident training in robotic general surgery cases in small community hospitals. The aim of this study is to provide more evidence regarding a robotics curriculum in a general surgery residency program at a small community hospital with one DaVinci Xi. Our current robotic training education program begins in the use of surgical simulators in a risk-free environment (“dry-lab”) to begin the development of basic robotic skills and bedside assistant training. The resident will advance to assisting at bedside in the operating room and eventually perform the procedures under the supervision of the robotic trained general surgeon.
Methods: 15 general surgery residents (PGY 1-5) without any exposure to robotic surgery were introduced to robotic training. All the residents were required to complete the online modules and dry robotic lab before scrubbing in robotic cases.
The dry-lab sessions were performed on Saturdays when the robot was readily available. The training involved the following exercises: peg transfer, right and left hand suturing, camera and clutching with ring tower transfer.
Interns were only allowed to learn bedside robotic assistance while PGY 2 and above were allowed to sit at the console once at least 15 cases at the bedside were performed.
Results: From January 2017 to September 2018, 103 robotic general surgery cases involving general surgery residents under the supervision of a single surgeon in a 297-bed community hospital. The cases included: 32 inguinal hernia repairs, 36 cholecystectomies, 24 ventral hernia repairs, 8 colectomies, 1 adrenalectomy, 1 paraesophageal hernia repair, 1 abdominoperineal resection. Each resident assisted bedside in about 12-15 cases. Each PGY3 and above resident performed 5 to 6 cases under the supervision of the surgeon. By the end, of the year chief residents were able to perform uncomplicated hernia repairs and cholecystectomy independently. 103 (100%) were completed robotically. There was 1 readmission within 30 days (0.9 %) and 5 patients with complications (4.8%), including 1 ventral hernia recurrence, 1 seroma, and 3 groin hematomas. There was 1 mortality (0.9%); after an uncomplicated outpatient cholecystectomy, the patient was readmitted overnight after cardiac arrest at home.
Conclusion: There is an increase in demand for robotic general surgery cases, which prompts residency programs to train their general surgery residents in basic robotic skills. General surgery residency programs should incorporate a formal robotics curriculum with simulation training and early robotic surgery exposure.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95516
Program Number: P681
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster