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Tou S, Au S, Clancy C, Clarke S, Collins D, Dixon F, Dreher E, Fleming C, Gallagher AG, Gomez-Ruiz M, Kleijnen J, Maeda Y, Rollins K, Matzel KE. European Society of Coloproctology guideline on training in robotic colorectal surgery (2024). Colorectal Dis 2024; 26:776-801. [PMID: 38429251 DOI: 10.1111/codi.16904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/14/2024] [Indexed: 03/03/2024]
Affiliation(s)
- Samson Tou
- Department of Colorectal Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
- School of Medicine, University of Nottingham, Derby, UK
| | | | - Cillian Clancy
- Department of Colorectal Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Steven Clarke
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Danielle Collins
- Department of Colorectal Surgery, Western General Hospital, NHS Lothian, Edinburgh, Scotland
| | - Frances Dixon
- Department of Colorectal Surgery, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK
| | - Elizabeth Dreher
- Department of Urology, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Christina Fleming
- Department of Colorectal Surgery, University Hospital Limerick, Limerick, Ireland
| | | | - Marcos Gomez-Ruiz
- Colorectal Surgery Unit, General Surgery Department, Marqués de Valdecilla University Hospital, Santander, Spain
- Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
| | - Jos Kleijnen
- Kleijnen Systematic Reviews Ltd, York, UK
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Yasuko Maeda
- Department of Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Katie Rollins
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Klaus E Matzel
- Section of Coloproctology, Department of Surgery, University of Erlangen-Nürnberg, FAU, Erlangen, Germany
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Yam C, DiMatteo A, Alnouri G, Sataloff RT. Otolaryngology resident familiarity with surgical instruments and preoperative setup: A pilot study. Am J Otolaryngol 2023; 44:103930. [PMID: 37229908 DOI: 10.1016/j.amjoto.2023.103930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/13/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE This study was designed to determine otolaryngology (ORL) residents' ability to prepare the operating room independently for ORL surgical cases and their familiarity with ORL surgical instruments and related equipment. METHODS A 24-question, one-time, anonymous survey was distributed to otolaryngology-head and neck surgery program directors for distribution among their residents in the United States in November 2022. Residents in every post-graduate year were surveyed. Spearman's ranked correlation and Mann-Whitney U test were used. RESULTS The response rate among program directors was 9.5 % (11/116 programs), while the response rate among residents was 51.5 % (88/171 residents). A total of 88 survey responses were completed. 61 % of ORL residents who responded were able to name most instruments used in surgical cases. The most recognized surgical instruments by ORL residents were microdebrider (99 %) and alligator forceps (98 %); the least recognized were bellucci micro scissors (72 %) and pituitary forceps (52 %); and all instruments except the microdebrider showed significantly increased recognition with increasing post graduate training year (PGY), p ≤ 0.05. ORL residents were most able to set up independently the electrocautery (77 %) and laryngoscope suspension (73 %), while they were least able to set up the robot laser (6.8 %) and coblator (26 %) independently. All instruments showed significant positive correlations with increasing PGY; the strongest correlation was found in laryngoscope suspension, r = 0.74. 48 % of ORL residents reported that there were times when surgical techs and nurses were not available. Only 54 % of ORL residents reported being able to set up instruments when alone in the operating room, including 77.8 % of PGY-5 residents. Only 8 % of residents reported receiving education related to surgical instruments from their residency program, while 85 % thought that ORL residencies should have courses or educational materials about surgical instruments. CONCLUSION ORL residents' familiarity with surgical instruments and preoperative setup improved throughout their training. However, specific instruments had much lower recognition than others and a lower ability for independent setup. Nearly half of ORL residents reported being unable to set up surgical instruments in the absence of surgical staff. Implementation of surgical instrument education may improve these deficiencies.
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Affiliation(s)
- Christopher Yam
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, United States of America.
| | - Andrew DiMatteo
- Department of Otolaryngology, Tripler Army Medical Center, Honolulu, HI, United States of America.
| | - Ghiath Alnouri
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, United States of America.
| | - Robert T Sataloff
- Department of Otolaryngology - Head and Neck Surgery, Senior Associate Dean for Clinical Academic Specialties, Drexel University College of Medicine, United States of America; Otolaryngology and Communication Sciences Research, Lankenau Institute for Medical Research, United States of America.
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Rahimi AO, Ho K, Chang M, Gasper D, Ashouri Y, Dearmon-Moore D, Hsu CH, Ghaderi I. A systematic review of robotic surgery curricula using a contemporary educational framework. Surg Endosc 2022; 37:2833-2841. [PMID: 36481821 DOI: 10.1007/s00464-022-09788-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 11/27/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND There has been a rising trend in robotic surgery. Thus, there is demand for a robotic surgery curriculum (RSC) for training surgical trainees and practicing surgeons. There are limited data available about current curricular designs and the extent to which they have incorporated educational frameworks. Our aim was to study the existing robotic surgery curricula using Kern's 6-step approach in curriculum development. METHODS A systematic review was conducted using PubMed, PubMed Central, Cochrane, Embase, and Scopus (we searched studies from 2001 to 2021). PRISMA Guidelines was used to guide the search. Curriculum designed for general surgery and its subspecialties were included. Urology and gynecology were excluded. The articles were reviewed by five reviewers. RESULTS Our review yielded 71 articles, including 39 curricula at 9 different settings. Using Kern's framework, we demonstrated that the majority of robotic surgery curricula contained all the elements of Kern's curricular design. However, there were significant deficiencies in important aspects of these curricula i.e., implementation, the quality of assessment tools for measurement of performance and evaluation of the educational value of these interventions. Most institutions used commercial virtual reality simulators (VRS) as the main component of their RSC and 23% of curricula only used VRS. CONCLUSIONS Although majority of these studies contained all the elements of Kern's framework, there are critical deficiencies in the components of existing curricula. Future curricula should be designed using established educational frameworks to improve the quality of robotic surgery training.
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Cepolina F, Razzoli RP. An introductory review of robotically assisted surgical systems. Int J Med Robot 2022; 18:e2409. [PMID: 35476899 PMCID: PMC9540802 DOI: 10.1002/rcs.2409] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/16/2022] [Accepted: 04/17/2022] [Indexed: 12/28/2022]
Abstract
Purpose The scope of the work is to present the state of the art of robotically assisted surgical systems and to give a general idea about how technology can help today and tomorrow robotic surgery. The road to innovation passes through research and on field trials; for this reason, not only commercial surgery robots, but also innovative prototype robots, proposed by the Academic world, are presented. Design/methodology/approach Following a short introduction, robotically assisted surgery systems are introduced discussing their architectures and main peculiarities. A further section is dedicated to the key enabling technologies that will make possible to improve current systems and that will lead to a new generation of surgical robotic systems able to meet the patient's needs and facilitate the surgeon's task. Finally, brief concluding comments are given. Findings The idea of using robots for surgery was born many years ago and in a short time a market demand was created. Today the market is very dynamic, and several new products are updated and created for the execution of both traditional and new procedures. The article provides a guide for the reader who has an interest in this area. Originality/value This paper provides an insight into the commercial robotic surgical systems and a look on research prototypes from academic and industrial worlds.
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Affiliation(s)
- Francesco Cepolina
- Department of Mechanical Engineering, Energy, Production, Transport and Mathematical Models (DIME) University of Genoa Genova Italy
| | - Roberto P. Razzoli
- Department of Mechanical Engineering, Energy, Production, Transport and Mathematical Models (DIME) University of Genoa Genova Italy
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Schlottmann F, Herbella FAM, Patti MG. Simulation for Foregut and Bariatric Surgery: Current Status and Future Directions. J Laparoendosc Adv Surg Tech A 2021; 31:546-550. [PMID: 33844957 DOI: 10.1089/lap.2021.0080] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Simulation offers the opportunity to practice in a safe, controlled, and standardized environment. Surgical simulation, in particular, is very attractive because it avoids learning and practicing surgical skills in the operating room. Many simulators are currently available such as box-lap trainers, virtual-reality platforms, cadavers, live animals, animal-based tissue blocks, and synthetic/artificial models. Endoscopic interventions can be practiced with high-fidelity virtual simulators. Box-lap trainers help practicing basic laparoscopic skills. Cadavers and live animals offer realism to train entire foregut and bariatric procedures. However, limited availability and high expenses often restrict their use. Ex vivo simulators with animal tissue blocks have been recently developed and appear to be a realistic and cost-effective alternative. Three-dimensional printing and real-time navigation systems have also emerged as promising training tools. Overall, further efforts are needed to develop a formal simulation curriculum with validated simulators for foregut and bariatric surgery.
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Affiliation(s)
| | | | - Marco G Patti
- Fellow American College of Surgeons, Chicago, Illinois, USA
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Sadava EE, Novitsky YW. Simulation in Hernia Surgery: Where Do We Stand? J Laparoendosc Adv Surg Tech A 2021; 31:551-555. [PMID: 33691482 DOI: 10.1089/lap.2021.0081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Simulation seems to be the best method of improving medical attitude, technical skills, and operating times. A literature review of the available data in simulation for hernia surgery was performed. Surgical simulation has been included as a main requirement in residency programs and endorsed by several surgical societies. However, evaluating how simulation affects patient's outcomes is challenging. In addition, simulation training represents an institutional economic burden that could undermine its implementation and development. Published data support that simulation-based training is a highly efficient tool, thus, its implementation should be strongly encouraged.
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Affiliation(s)
- Emmanuel E Sadava
- Division of Abdominal Wall Surgery, Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina
| | - Yuri W Novitsky
- Comprehensive Hernia Center, Columbia University Medical Center, New York, New York, USA
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McCrary HC, McLean SR, Luman A, O'Sullivan P, Smith B, Cannon RB. A National Survey of Robotic Surgery Training Among Otolaryngology-Head and Neck Surgery Residents. Ann Otol Rhinol Laryngol 2021; 130:1085-1092. [PMID: 33615826 DOI: 10.1177/0003489421996968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study is to describe the current state of robotic surgery training among Otolaryngology-Head and Neck Surgery (OHNS) residency programs in the United States. METHODS This is a national survey study among OHNS residents. All OHNS residency programs were identified via the Accreditation Council for Graduate Medical Education website. A total of 64/127 (50.3%) of OHNS programs were selected based on a random number generator. The main outcome measure was the number of OHNS residents with access to robotic surgery training and assessment of operative experience in robotic surgery among those residents. RESULTS A total of 140 OHNS residents participated in the survey, of which 59.3% (n = 83) were male. Response rate was 40.2%. Respondents came from middle 50.0% (n = 70), southern 17.8% (n = 25), western 17.8% (n = 25), and eastern sections 14.3% (n = 20). Most respondents (94.3%, n = 132) reported that their institution utilized a robot for head and neck surgery. Resident experience at the bedside increased in the junior years of training and console experience increased across the years particularly for more senior residents. However, 63.4% of residents reported no operative experience at the console. Only 11.4% of programs have a structured robotics training program. CONCLUSION This survey indicated that nearly all OHNS residencies utilize robotic surgery in their clinical practice with residents receiving little formal education in robotics or experience at the console. OHNS residencies should aim to increase access to training opportunities in order to increase resident competency. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Hilary C McCrary
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Sierra R McLean
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Abigail Luman
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Patricia O'Sullivan
- University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Brigitte Smith
- Department of Surgery, Division of Vascular Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Richard B Cannon
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Utah Health Sciences Center, Salt Lake City, UT, USA
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Schlottmann F, Tolleson-Rinehart S, Kibbe MR, Patti MG. Status of Simulation-Based Training in Departments of Surgery in the United States. J Surg Res 2020; 255:158-163. [DOI: 10.1016/j.jss.2020.05.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/13/2020] [Accepted: 05/03/2020] [Indexed: 02/07/2023]
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Abstract
PURPOSE OF REVIEW The goal of this paper was to identify areas of importance in modern urology education that are not currently emphasized in current urological curricula. RECENT FINDINGS We identified curricular deficits in robotic surgical simulation, transgender health, leadership, business management, and social media training. Few practicing urologists feel comfortable managing transgender-specific needs, and most training programs do not adequately address transgender health. Urology programs also do not sufficiently emphasize topics in leadership, business management, or appropriate social media usage. With respect to simulation, while it is currently included in the Accreditation Council for Graduate Medical Education (ACGME) program requirements, it is currently under-utilized for training in robotic surgery. It is important for urologists to receive adequate training for the modern practice landscape. Where knowledge gaps among early practicing urologists arise, programs should adapt their curricula to address them.
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MacCraith E, Forde JC, Davis NF. Robotic simulation training for urological trainees: a comprehensive review on cost, merits and challenges. J Robot Surg 2019; 13:371-377. [PMID: 30796671 DOI: 10.1007/s11701-019-00934-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 02/18/2019] [Indexed: 12/11/2022]
Abstract
Simulation in surgery is a safe and cost-effective way of training. Operating room performance is improved after simulation training. The necessary attributes of surgical simulators are acceptability and cost-effectiveness. It is also necessary for a simulator to demonstrate face, content, predictive, construct and concurrent validity. Urologists have embraced robot-assisted surgery. These procedures require steep learning curves. There are 6 VR simulators available for robot-assisted surgery; the daVinci Skills Simulator (dVSS), the Mimic dV Trainer (MdVT), the ProMIS simulator, the Simsurgery Educational Platform (SEP) simulator, the Robotic Surgical Simulator (RoSS) and the RobotiX Mentor (RM). Their efficacy is limited by the lack of comparative studies, standardisation of validation and high cost. There are a number of robotic surgery training curricula developed in recent years which successfully include simulation training. There are growing calls for these simulators to be incorporated into the urology training curriculum globally to shorten the learning curve without compromising patient safety. Surgical educators in urology should aim to develop a cost-effective, acceptable, validated simulator that can be incorporated into a standardised, validated robot-assisted surgery training curriculum for the next generation of robotic surgeons.
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Affiliation(s)
- Eoin MacCraith
- Department of Urology, Connolly Hospital, Blanchardstown, Dublin 15, Ireland.
| | - James C Forde
- Department of Urology, Connolly Hospital, Blanchardstown, Dublin 15, Ireland
| | - Niall F Davis
- Department of Urology, The Austin Hospital, Melbourne, Australia
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Clark CE, Turner JS, Kpodzo D, Reid KM, Hobson L, Moore C, Childs E, Clark K, Dansby M, Chase A, Johnson S. Adopting Robotics Training into a General Surgery Residency Curriculum: Where Are We Now? CURRENT SURGERY REPORTS 2019. [DOI: 10.1007/s40137-019-0225-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Moldes JM, de Badiola FI, Vagni RL, Mercado P, Tuchbaum V, Machado MG, López PJ. Pediatric Robotic Surgery in South America: Advantages and Difficulties in Program Implementation. Front Pediatr 2019; 7:94. [PMID: 30984719 PMCID: PMC6447650 DOI: 10.3389/fped.2019.00094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/04/2019] [Indexed: 11/21/2022] Open
Abstract
Robotic assisted laparoscopic surgery is gaining popularity around the world due to its vast benefits. Although it has been established mainly in developed countries, in South America the robotic programs have become more popular, but its growth is clearly slower. Information about robotic pediatric surgery program in Brazil, Chile, Uruguay, and Argentina was collected through e-mail surveys. Results were analyzed and compared to worldwide information about robotic surgery. Due to the wide social, economical, and technological gap between hospitals in South America, it is hard to develop a proper pediatric robotic surgery program. The main obstacles in those four countries appear to be a combination of high purchase costs and equipment maintenance, lack of financial coverage of the procedure by insurance companies and the absence of significant benefits proved in pediatrics in relation to laparoscopic surgery. The pediatric specialties are in the process of making and implementing robotic programs supported by the evident development in adult specialties. However, pediatric robotic surgery in Brazil, Chile, Uruguay and Argentina do not seems to share that growth.
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Affiliation(s)
- Juan M Moldes
- Department Pediatric Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Roberto Luis Vagni
- Department Pediatric Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Pedro Mercado
- Department Pediatric Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Virginia Tuchbaum
- Department Pediatric Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Marcos G Machado
- Department of Urology, Faculdade de Medicina, Universidade de São Paulo, Hospital das Clínicas, São Paulo, Brazil
| | - Pedro José López
- Department Pediatric Urology, Hospital Exequiel Gonzalez Cortés y Clínica Alemana, Santiago, Chile
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