Department of Urology, University of California-Irvine, Orange, California 92868, USA.
J Urol. 2011 Apr;185(4):1191-7. doi: 10.1016/j.juro.2010.11.067. Epub 2011 Feb 22.
PURPOSE: With the rapid and widespread adoption of robotics in surgery, the minimally invasive surgical landscape has changed markedly within the last half decade. This change has had a significant impact on patients, surgeons and surgical trainees. This is no more apparent than in the field of urology. As with the advent of any new surgical technology, it is imperative that we develop comprehensive and responsible training and credentialing initiatives to ensure surgical outcomes and patient safety are not compromised during the learning process. MATERIALS AND METHODS: A literature search was conducted on surgical training curricula as well as robotic surgery training and credentialing to provide best practice recommendations for the development of a robotic surgery training curriculum and credentialing process. RESULTS: For trainees to attain the requisite knowledge and skills to provide safe and effective patient care, surgical training in robotics should involve a structured, competency based curriculum that allows the trainee to progress in a graduated fashion. This structured curriculum should involve preclinical and clinical components to facilitate the proper adoption and application of this new technology. Robotic surgery credentialing should involve an expert determined, standardized educational process, including a minimum criterion of proficiency. CONCLUSIONS: Rather than being based on a set number of completed cases, robotic surgery credentialing should involve the demonstration of proficiency and safety in executing basic robotic skills and procedural tasks. In addition, the accreditation process should be iterative to ensure accountability to the patient.
目的:随着机器人技术在外科手术中的快速广泛应用,微创外科领域在过去五年中发生了显著变化。这种变化对患者、外科医生和外科受训者都产生了重大影响。在泌尿科领域尤为明显。与任何新的外科技术一样,至关重要的是,我们要制定全面和负责任的培训和认证计划,以确保在学习过程中不会影响手术效果和患者安全。
材料和方法:对外科培训课程以及机器人手术培训和认证进行了文献检索,为机器人手术培训课程和认证流程的制定提供了最佳实践建议。
结果:为了使受训者获得提供安全有效的患者护理所需的知识和技能,机器人手术培训应包括一个结构化、基于能力的课程,使受训者能够逐步取得进步。这个结构化的课程应该包括临床前和临床部分,以促进这项新技术的正确采用和应用。机器人手术认证应涉及专家确定的标准化教育过程,包括最低熟练标准。
结论:机器人手术认证不应基于完成的手术数量,而应包括演示执行基本机器人技能和程序任务的熟练程度和安全性。此外,认证过程应具有迭代性,以确保对患者负责。
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