Department of General, Visceral, Vascular, and Transplant Surgery, Otto-von-Guericke University, Magdeburg, Germany.
Medical Faculty, University Magdeburg, Magdeburg, Germany.
J Robot Surg. 2024 Aug 6;18(1):307. doi: 10.1007/s11701-024-02056-9.
The "Robotic Curriculum for young Surgeons" (RoCS) was launched 03/2020 to address the increasing importance of robotics in surgical training. It aims to provide residents with foundational robotic skills by involving them early in their training. This study evaluated the impact of RoCS' integration into clinical routine on patient outcomes. Two cohorts were compared regarding the implementation of RoCS: Cohort 1 (before RoCS) included all robot-assisted procedures between 2017 and 03/2020 (n = 174 adults) retrospectively; Cohort 2 (after RoCS) included all adults (n = 177) who underwent robotic procedures between 03/2020 and 2021 prospectively. Statistical analysis covered demographics, perioperative parameters, and follow-up data, including mortality and morbidity. Subgroup analysis for both cohorts was organ-related (upper gastrointestinal tract (UGI), colorectal (CR), hepatopancreaticobiliary system (HPB)). Sixteen procedures were excluded due to heterogeneity. In-hospital, 30-, 90-day morbidity and mortality showed no significant differences between both cohorts, including organ-related subgroups. For UGI, no significant intraoperative parameter changes were observed. Surgery duration decreased significantly in CR and HPB procedures (p = 0.018 and p < 0.001). Estimated blood loss significantly decreased for CR operations (p = 0.001). The conversion rate decreased for HPB operations (p = 0.005). Length of hospitalization decreased for CR (p = 0.015) and HPB (p = 0.006) procedures. Oncologic quality, measured by histopathologic R0-resections, showed no significant changes. RoCS can be safely integrated into clinical practice without compromising patient safety or oncologic quality. It serves as an effective training pathway to guide robotic novices through their first steps in robotic surgery, offering promising potential for skill acquisition and career advancement.
“年轻外科医生机器人课程”（RoCS）于 2020 年 3 月推出，旨在解决机器人技术在外科培训中日益重要的问题。它旨在通过让住院医师在培训早期参与其中，为他们提供基础机器人技能。本研究评估了将 RoCS 纳入临床常规对患者结局的影响。比较了两个队列在实施 RoCS 方面的差异：队列 1（RoCS 之前）包括 2017 年至 2020 年 3 月期间回顾性所有机器人辅助手术（n=174 例成人）；队列 2（RoCS 之后）包括 2020 年 3 月至 2021 年期间前瞻性所有成人（n=177 例）接受机器人手术。统计分析涵盖了人口统计学、围手术期参数和随访数据，包括死亡率和发病率。对两个队列进行了器官相关的亚组分析（上消化道（UGI）、结直肠（CR）、肝胆胰腺系统（HPB））。由于异质性，排除了 16 个程序。RoCS 前后两组的住院、30 天和 90 天发病率和死亡率，包括器官相关亚组，均无显著差异。在 UGI 中，没有观察到术中参数的显著变化。CR 和 HPB 手术的手术时间显著缩短（p=0.018 和 p<0.001）。CR 手术的估计失血量显著减少（p=0.001）。HPB 手术的转化率降低（p=0.005）。CR（p=0.015）和 HPB（p=0.006）手术的住院时间缩短。通过组织病理学 R0 切除测量的肿瘤质量没有显著变化。RoCS 可以安全地整合到临床实践中，而不会危及患者安全或肿瘤质量。它是指导机器人新手进行机器人手术的有效培训途径，为技能获取和职业发展提供了有前途的潜力。
