Shakir T, Lingam G, Boal M, Chand M, Francis N
University College London, London, UK.
Colorectal Surgery, St Marks Hospital & Academic Institute, London, UK.
Surg Endosc. 2025 Sep 5. doi: 10.1007/s00464-025-12144-y.
Robotic surgery has witnessed rapid growth and development, with a concomitant training requirement. However, educational methods can vary, for example, industry or clinician led. This can result in heterogeneous training. This study aimed to develop a standardised method for the setup and docking of a robotic platform through expert consensus.
A steering committee of robotic surgeons, surgical care practitioners, and industry representatives formulated initial statements for an online Delphi consensus. The process involved three rounds of voting, with consensus defined as over 80% agreement. Participants included members of societal robotics subcommittees and experienced robotic surgical mentors from 13 countries. The consensus statements were divided into five categories: pre-operative considerations, port placement, driving in and docking, instruments and changes, and undocking and driving out.
57 invitations, alongside a social media advertisement, resulted in 63 responses in round one. Rounds two and three had 54 and 52 responses, respectively (85.7% and 96.3% inter-round response rates). Respondents were from 13 countries, with 73% consultants/attendings, 19% surgical care practitioners/first assistants, and 8% fellows. 73% operate in multiple anatomical regions, primarily pelvic, lower, and upper abdominal. Most respondents had significant robotic experience, with 61.9% involved in over 500 cases. The importance of pre-operative considerations included the necessity of naming components, understanding vision cart functions, and emergency undocking procedures. Standardised port placement and docking techniques were established to ensure optimal access and safety. The use of reverse communication to ensure safety with instrument insertion and changes was emphasised with high levels of consensus.
The consensus identified best practices in hardware knowledge, emergency undocking, port placement, docking, instrument handling, and undocking procedures. This aims to standardise training protocols and has the potential to form part of assessment and accreditation. Further research is required to validate these findings.
机器人手术发展迅速，随之而来的是培训需求。然而，教育方法可能各不相同，例如由行业或临床医生主导。这可能导致培训的异质性。本研究旨在通过专家共识制定一种机器人平台设置和对接的标准化方法。
由机器人外科医生、手术护理从业者和行业代表组成的指导委员会为在线德尔菲共识制定初始声明。该过程包括三轮投票，共识定义为超过80%的同意率。参与者包括社会机器人学小组委员会成员和来自13个国家的经验丰富的机器人手术导师。共识声明分为五类：术前考虑、端口放置、驶入和对接、器械及更换、退出对接和驶出。
57份邀请函以及社交媒体广告在第一轮中收到了63份回复。第二轮和第三轮分别有54份和52份回复（两轮之间的回复率分别为85.7%和96.3%）。受访者来自13个国家，73%为顾问/主治医生，19%为手术护理从业者/第一助手，8%为研究员。73%的人在多个解剖区域进行手术，主要是盆腔、下腹部和上腹部。大多数受访者有丰富的机器人手术经验，61.9%的人参与过500多例手术。术前考虑的重要性包括部件命名的必要性、视觉推车功能的理解以及紧急退出对接程序。建立了标准化的端口放置和对接技术以确保最佳的操作通道和安全性。通过高度共识强调了使用反向通信以确保器械插入和更换时的安全。
该共识确定了硬件知识、紧急退出对接、端口放置、对接、器械操作和退出对接程序方面的最佳实践。这旨在使培训方案标准化，并有可能成为评估和认证的一部分。需要进一步的研究来验证这些发现。
