Educational impact of robot assisted surgical training program

S. Khan, S. Raza, K. Ahmed, R. Din, A. Stegemann, M. Bienko, A. Chowriappa, T. Kesavadas, M. Bhandari, K. Guru

Guy’s and St Thomas’ NHS Foundation Trust, Roswell Park Cancer Institute, Guy’s Hospital, Roswell Park Cance

Introduction & Objectives
Robot assisted surgery has been incorporated into the surgical armamentarium and generated interest among practicing non-robotic surgeons (NRS). We evaluated whether our Robot-assisted Surgical Training (RAST) Program would enable NRS to incorporate this new skill into their clinical expertise. This study aims to establish educational impact and acceptability of the curriculum.

Materials & Methods
A formal RAST Program was established at Roswell Park Cancer Institute in 2007. From July 2010 to October 2012, 43 non-robotic surgeons (US: , International: ) participated in the RAST program. The 5-day to 3-week program include a Fundamental of Robotic Surgery (FSRS) curriculum, Bedside Hands on trouble shooting training, case observation, Hands On Surgical Training (HoST) procedure module; da-Vinci Robotic Surgical hands on Experience and finally an animal laboratory. As part of our training & credentialing quality assurance program, pre and post program follow-up questionnaires evaluating the quality and feedback for improvement routinely used as a measure at regular intervals were evaluated. This survey aims to evaluate impact of the educational intervention at a delayed interval when participants were back to their practice as independently performing surgeons.

Results
43 non-robotic surgeons participated in our RAST program over 27 months. The response rate to the questionnaires was 85 %. The average follow-up period since completion of program was 6 months (2-19). Only 13% surgeons had performed any robot-assisted surgery before completion of the program. Two participants had performed other training program for robot-assisted surgery before embarking on our program. 81%, 7%, 66% participants felt FSRS curriculum, bedside trouble shooting and animal laboratory were beneficial in getting acquainted with basic principles of robot-assisted surgery respectively. 61% participants were performing robot-assisted surgery in three surgical specialties (urology, gynecology and gastrointestinal surgery). Robot-assisted radical prostatectomy and gastrointestinal surgeries were the two commonest performed procedures performed after completion respectively. 12 surgeons had performed the procedures independently; meanwhile 8 performed them under supervision of another surgeon. 61 % non-robotic surgeons performed robot-assisted surgery at an average of 5 weeks (1-24) after completion of RAST program. 2% conversion rate to open surgery was reported due to difficult bladder neck and post transurethral resection of prostate in robot-assisted radical prostatectomy and one patient with a large gynecologic tumor.

Conclusions
A dedicated surgical training program focused on learning key steps of robot-assisted surgery enabled most participants to successfully incorporate and maintain their robot-assisted surgical skills in clinical practice. A program if its kind certainly has educational impact and is acceptable to the participants.

Session: Poster Presentation

Program Number: ETP019