Unruh Kenley, Stovall Stephanie, Chang Lily, Deal Shanley, Kaplan Jennifer A, Moonka Ravi, Simianu Vlad V
Department of Surgery, Virginia Mason Franciscan Health, Virginia Mason Medical Center, 1100 9Th Ave, Seattle, WA, 98101, USA.
J Robot Surg. 2023 Oct;17(5):2331-2338. doi: 10.1007/s11701-023-01660-5. Epub 2023 Jun 28.
There is increasing demand for colorectal robotic training for general surgery residents. We implemented a robotic colorectal surgery curriculum expecting that it would increase resident exposure to the robotic platform and would increase the number of graduating general surgery residents obtaining a robotic equivalency certificate. The aim of this study is to describe the components of the curriculum and characterize the immediate impact of the implementation or residents. Our curriculum started in 2019 and consists of didactics, simulation, and clinical performance. Objectives are specified for both junior residents (post-graduate years [PGY]1-2) and senior residents (PGY3-5). The robotic colorectal surgical experience was characterized by comparing robotic to non-robotic operations, differences in robotic operations across post-graduate year, and percentage of graduates achieving an equivalency certificate. Robotic operations are tracked using case log annotation. From 2017 to 2021, 25 residents logged 681 major operations on the colorectal service (PGY1 mean = 7.6 ± 4.6, PGY4 mean = 29.7 ± 14.4, PGY5 mean = 29.8 ± 14.8). Robotic colorectal operations made up 24% of PGY1 (49% laparoscopic, 27% open), 35% of PGY4 (35% laparoscopic, 29% open), and 41% of PGY5 (44% laparoscopic, 15% open) major colorectal operations. Robotic bedside experience is primarily during PGY1 (PGY1 mean 2.0 ± 2.0 bedside operations vs 1.4 ± 1.6 and 0.2 ± 0.4 for PGY4 and 5, respectively). Most PGY4 and 5 robotic experience is on the console (PGY4 mean 9.1 ± 7.7 console operations, PGY5 mean 12.0 ± 4.8 console operations). Rates of robotic certification for graduating chief residents increased from 0% for E-2013 to 100% for E-2018. Our robotic colorectal curriculum for general surgery residents has facilitated earlier and increased robotic exposure for residents and increased robotic certification for our graduates.
普通外科住院医师对结直肠机器人手术培训的需求日益增加。我们实施了一项机器人结直肠手术课程，期望它能增加住院医师接触机器人平台的机会，并增加获得机器人手术等效证书的普通外科住院医师的毕业人数。本研究的目的是描述该课程的组成部分，并描述其实施对住院医师的直接影响。我们的课程于2019年开始，包括理论教学、模拟和临床实践。为初级住院医师（研究生第1-2年）和高级住院医师（研究生第3-5年）都设定了目标。通过比较机器人手术与非机器人手术、不同研究生年级的机器人手术差异以及获得等效证书的毕业生百分比，来描述机器人结直肠手术经验。使用病例日志注释来跟踪机器人手术。2017年至2021年，25名住院医师在结直肠科室记录了681例大手术（研究生第1年平均为7.6±4.6例，研究生第4年平均为29.7±14.4例，研究生第5年平均为29.8±14.8例）。机器人结直肠手术占研究生第1年大结直肠手术的24%（49%为腹腔镜手术，27%为开放手术），研究生第4年的35%（35%为腹腔镜手术，29%为开放手术），研究生第5年的41%（44%为腹腔镜手术，15%为开放手术）。机器人床边经验主要在研究生第1年（研究生第1年平均2.0±2.0例床边手术，而研究生第4年和第5年分别为1.4±1.6例和0.2±0.4例）。大多数研究生第4年和第5年的机器人手术经验是在控制台（研究生第4年平均9.1±7.7例控制台手术，研究生第5年平均12.0±4.8例控制台手术）。毕业总住院医师的机器人手术认证率从2013届的0%提高到2018届的100%。我们为普通外科住院医师开设的机器人结直肠手术课程促进了住院医师更早且更多地接触机器人手术，并提高了我们毕业生的机器人手术认证率。
