Hoekstra Anna V, Morgan Jacqueline M, Lurain John R, Buttin Barbara M, Singh Diljeet K, Schink Julian C, Lowe M Patrick
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Robert H Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Gynecol Oncol. 2009 Aug;114(2):168-72. doi: 10.1016/j.ygyno.2009.04.022. Epub 2009 May 15.
To report the impact of a new robotic surgery program on the surgical training of gynecologic oncology fellows over a 12 month period of time.
A robotic surgery program was introduced into the gynecologic oncology fellowship program at Northwestern University Feinberg School of Medicine in June 2007. A database of patients undergoing surgical management of endometrial and cervical cancer between July 2007 and July 2008 was collected and analyzed. Changes in fellow surgical training were measured and analyzed.
Fellow surgical training for endometrial and cervical cancer underwent a dramatic transition in 12 months. The proportion of patients undergoing minimally invasive surgery increased from 3.3% (4/110 patients) to 43.5% (47/108 patients). Fellow training transitioned from primarily an open approach (94.4%) to a minimally invasive approach (11% laparoscopic, 49% robotic, 40% open) for endometrial cancer stagings, and from an open approach (100%) to an open (50%) and robotic (50%) approach for radical hysterectomies. Fellow participation in robotic procedures increased from 45% in the first 3 months to 72% within 6 months, and 92% by 12 months. The role of the fellow in robotic cases transitioned from bedside assistant to console operator within 3 months.
Fellow surgical training underwent a dramatic change with the introduction of a robotic surgery program. The management of endometrial and cervical cancer was impacted the most by robotics. Robotic surgery broadened fellowship surgical training, but balanced surgical training and standardized fellow training modules remain challenges for fellowship programs.
报告一项新的机器人手术项目在12个月期间对妇科肿瘤学住院医师外科培训的影响。
2007年6月，机器人手术项目被引入西北大学费恩柏格医学院的妇科肿瘤学住院医师培训项目。收集并分析了2007年7月至2008年7月期间接受子宫内膜癌和宫颈癌手术治疗患者的数据库。对住院医师外科培训的变化进行了测量和分析。
住院医师对子宫内膜癌和宫颈癌的外科培训在12个月内发生了巨大转变。接受微创手术的患者比例从3.3%（4/110例患者）增至43.5%（47/108例患者）。对于子宫内膜癌分期，住院医师培训从主要采用开放手术方式（94.4%）转变为微创方式（11%腹腔镜、49%机器人手术、40%开放手术）；对于根治性子宫切除术，从开放手术方式（100%）转变为开放手术（50%）和机器人手术（50%）方式。住院医师参与机器人手术的比例从最初3个月的45%增至6个月内的72%，到12个月时达到92%。住院医师在机器人手术病例中的角色在3个月内从床边助手转变为控制台操作员。
随着机器人手术项目的引入，住院医师外科培训发生了巨大变化。机器人手术对子宫内膜癌和宫颈癌的治疗影响最大。机器人手术拓宽了住院医师的外科培训，但平衡手术培训和标准化住院医师培训模块仍是住院医师培训项目面临的挑战。
