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程序性机器人手术培训:一项英国多专业受训人员德尔菲共识研究。

Procedural robotic surgery training: a UK pan-specialty trainee Delphi consensus study.

作者信息

Harris Matthew, Bannon Aidan, Collins Justin W

机构信息

Association of Surgeons in Training, Royal College of Surgeons of England, 38-43 Lincoln's Inn Fields, London, WC2A 3PE, UK.

Robotic and Digital Surgery Trainee's Committee, Royal College of Surgeons of England, 38-43 Lincoln's Inn Fields, London, UK.

出版信息

J Robot Surg. 2025 Aug 21;19(1):501. doi: 10.1007/s11701-025-02582-0.

Abstract

Robotic surgery has become increasingly prevalent in the UK, with 65% of the population living within a 30-min drive of a robotic surgical centre. However, many surgical trainees lack access to structured robotic training, highlighting the need for standardised pathways to equip future surgeons. This study seeks to determine a consensus amongst UK surgical trainees on the opinion of essential components of procedural robotic training. A trainee-led Delphi consensus study was conducted with 85 surgical trainees representing the spectrum of surgical specialism and training grades. A steering group consisting of a surgical expert and trainee representatives developed and refined statements across key themes, including robotic curricula, credentialling structure, assessment standards, error metrics and access to training. Trainee feedback was collected through three iterative survey rounds, with consensus defined as ≥ 80% agreement or disagreement. Consensus was achieved for 82 of 141 statements. Trainees strongly supported the integration of robotic training into surgical curricula, emphasising the importance of metrics-based assessment and credentialling in device, basic and procedural training. Key recommendations included platform-agnostic training, benchmarking, proficiency-based progression, and video-based assessments for procedural skills. Additional endorsements included revalidation every 5 years and centralised registries for robotic cases. Flexible access to training, beginning at higher specialty levels, was also advocated. This study establishes a robust consensus amongst UK surgical trainees, highlighting the acceptability of credentialling in robotic surgery. The findings provide a framework for developing equitable and standardised robotic training pathways to ensure the preparedness of future surgeons in an evolving surgical landscape.

摘要

机器人手术在英国越来越普遍,65%的人口居住在距离机器人手术中心30分钟车程内。然而,许多外科住院医师缺乏结构化的机器人手术培训,这凸显了为未来外科医生配备标准化培训途径的必要性。本研究旨在就程序性机器人手术培训的基本组成部分,在英国外科住院医师中达成共识。我们开展了一项由住院医师主导的德尔菲共识研究,85名外科住院医师参与其中,他们代表了外科专业和培训等级的各个层面。一个由外科专家和住院医师代表组成的指导小组围绕关键主题制定并完善了相关陈述,这些主题包括机器人手术课程、资质认定结构、评估标准、错误指标以及培训机会。通过三轮迭代调查收集住院医师的反馈,将≥80%的同意或不同意定义为达成共识。141条陈述中有82条达成了共识。住院医师强烈支持将机器人手术培训纳入外科课程,强调基于指标的评估以及在设备、基础和程序性培训中的资质认定的重要性。关键建议包括与平台无关的培训、基准测试、基于熟练程度的进阶以及针对程序性技能的视频评估。其他支持措施包括每5年重新认证以及建立机器人手术病例的集中登记系统。还提倡从更高专业级别开始提供灵活的培训机会。本研究在英国外科住院医师中达成了强有力的共识,凸显了机器人手术资质认定的可接受性。研究结果为制定公平且标准化的机器人手术培训途径提供了框架,以确保未来外科医生在不断发展的手术领域做好准备。

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