Mirheydar Hossein, Jones Marklyn, Koeneman Kenneth S, Sweet Robert M
Department of Urologic Surgery, University of Minnesota, Minneapolis, 55455, USA.
JSLS. 2009 Jul-Sep;13(3):287-92.
Currently, robotic training for inexperienced, practicing surgeons is primarily done vis-à-vis industry and/or society-sponsored day or weekend courses, with limited proctorship opportunities. The objective of this study was to assess the impact of an extended-proctorship program at up to 32 months of follow-up.
An extended-proctorship program for robotic-assisted laparoscopic radical prostatectomy was established at our institution. The curriculum consisted of 3 phases: (1) completing an Intuitive Surgical 2-day robotic training course with company representatives; (2) serving as assistant to a trained proctor on 5 to 6 cases; and (3) performing proctored cases up to 1 year until confidence was achieved. Participants were surveyed and asked to evaluate on a 5-point Likert scale their operative experience in robotics and satisfaction regarding their training.
Nine of 9 participants are currently performing robotic-assisted laparoscopic radical prostatectomy (RALP) independently. Graduates of our program have performed 477 RALP cases. The mean number of cases performed within phase 3 was 20.1 (range, 5 to 40) prior to independent practice. The program received a rating of 4.2/5 for effectiveness in teaching robotic surgery skills.
Our robotic program, with extended proctoring, has led to an outstanding take-rate for disseminating robotic skills in a metropolitan community.
目前，针对缺乏经验的执业外科医生的机器人手术培训主要是通过参加由行业和/或社会赞助的日间或周末课程进行，且带教机会有限。本研究的目的是评估一项长达32个月随访期的延长带教计划的影响。
我们机构设立了一项针对机器人辅助腹腔镜根治性前列腺切除术的延长带教计划。课程包括三个阶段：（1）与公司代表一起完成直观外科公司为期2天的机器人手术培训课程；（2）作为经过培训的带教人员的助手参与5至6例手术；（3）在带教下进行手术直至1年，直至获得信心。对参与者进行了调查，并要求他们使用5分制李克特量表对自己的机器人手术操作经验和培训满意度进行评估。
9名参与者中有9名目前正在独立进行机器人辅助腹腔镜根治性前列腺切除术（RALP）。我们计划的毕业生已完成477例RALP手术。在独立执业前，第三阶段平均完成的手术例数为20.1例（范围为5至40例）。该计划在教授机器人手术技能方面的有效性获得了4.2/5的评分。
我们的机器人手术计划，通过延长带教，在一个大都市社区中，在传播机器人手术技能方面取得了出色的接受率。
