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Published in: Journal of Robotic Surgery 1/2024

Open Access 01-12-2024 | Gastroenterostomy | Research

Conception and prospective multicentric validation of a Robotic Surgery Training Curriculum (RoSTraC) for surgical residents: from simulation via laboratory training to integration into the operation room

Authors: Michael Thomaschewski, Markus Kist, Markus Zimmermann, Claudia Benecke, Jörg C. Kalff, Colin M. Krüger, Benno Mann, Andreas Türler, Tobias Keck, Richard Hummel

Published in: Journal of Robotic Surgery | Issue 1/2024

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Abstract

There is a lack of training curricula and educational concepts for robotic-assisted surgery (RAS). It remains unclear how surgical residents can be trained in this new technology and how robotics can be integrated into surgical residency training. The conception of a training curriculum for RAS addressing surgical residents resulted in a three-step training curriculum including multimodal learning contents: basics and simulation training of RAS (step 1), laboratory training on the institutional robotic system (step 2) and structured on-patient training in the operating room (step 3). For all three steps, learning content and video tutorials are provided via cloud-based access to allow self-contained training of the trainees. A prospective multicentric validation study was conducted including seven surgical residents. Transferability of acquired skills to a RAS procedure were analyzed using the GEARS score. All participants successfully completed RoSTraC within 1 year. Transferability of acquired RAS skills could be demonstrated using a RAS gastroenterostomy on a synthetic biological organ model. GEARS scores concerning this procedure improved significantly after completion of RoSTraC (17.1 (±5.8) vs. 23.1 (±4.9), p < 0.001). In step 3 of RoSTraC, all participants performed a median of 12 (range 5–21) RAS procedures on the console in the operation room. RoSTraC provides a highly standardized and comprehensive training curriculum for RAS for surgical residents. We could demonstrate that participating surgical residents acquired fundamental and advanced RAS skills. Finally, we could confirm that all surgical residents were successfully and safely embedded into the local RAS team.
Literature
1.
go back to reference Tang CL, Schlich T (2017) Surgical innovation and the multiple meanings of randomized controlled trials: the first RCT on minimally invasive cholecystectomy (1980–2000). J Hist Med Allied Sci 72:117–141PubMed Tang CL, Schlich T (2017) Surgical innovation and the multiple meanings of randomized controlled trials: the first RCT on minimally invasive cholecystectomy (1980–2000). J Hist Med Allied Sci 72:117–141PubMed
2.
go back to reference Zendejas B, Brydges R, Hamstra SJ, Cook DA (2013) State of the evidence on simulation-based training for laparoscopic surgery: a systematic review. Ann Surg 257:586–593CrossRefPubMed Zendejas B, Brydges R, Hamstra SJ, Cook DA (2013) State of the evidence on simulation-based training for laparoscopic surgery: a systematic review. Ann Surg 257:586–593CrossRefPubMed
3.
go back to reference Ahlberg G, Enochsson L, Gallagher AG, Hedman L, Hogman C, McClusky DA 3rd, Ramel S, Smith CD, Arvidsson D (2007) Proficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies. Am J Surg 193:797–804CrossRefPubMed Ahlberg G, Enochsson L, Gallagher AG, Hedman L, Hogman C, McClusky DA 3rd, Ramel S, Smith CD, Arvidsson D (2007) Proficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies. Am J Surg 193:797–804CrossRefPubMed
4.
go back to reference Nugent E, Shirilla N, Hafeez A, O’Riordain DS, Traynor O, Harrison AM, Neary P (2013) Development and evaluation of a simulator-based laparoscopic training program for surgical novices. Surg Endosc 27:214–221CrossRefPubMed Nugent E, Shirilla N, Hafeez A, O’Riordain DS, Traynor O, Harrison AM, Neary P (2013) Development and evaluation of a simulator-based laparoscopic training program for surgical novices. Surg Endosc 27:214–221CrossRefPubMed
5.
go back to reference Ritter EM, Scott DJ (2007) Design of a proficiency-based skills training curriculum for the fundamentals of laparoscopic surgery. Surg Innov 14:107–112CrossRefPubMed Ritter EM, Scott DJ (2007) Design of a proficiency-based skills training curriculum for the fundamentals of laparoscopic surgery. Surg Innov 14:107–112CrossRefPubMed
6.
go back to reference Laubert T, Esnaashari H, Auerswald P, Höfer A, Thomaschewski M, Bruch H-P, Keck T, Benecke C (2018) Conception of the Lübeck Toolbox curriculum for basic minimally invasive surgery skills. Langenbecks Arch Surg 403:271–278PubMed Laubert T, Esnaashari H, Auerswald P, Höfer A, Thomaschewski M, Bruch H-P, Keck T, Benecke C (2018) Conception of the Lübeck Toolbox curriculum for basic minimally invasive surgery skills. Langenbecks Arch Surg 403:271–278PubMed
7.
go back to reference Valdis M, Chu MWA, Schlachta C, Kiaii B (2016) Evaluation of robotic cardiac surgery simulation training: a randomized controlled trial. J Thorac Cardiovasc Surg 151:1498-1505.e2CrossRefPubMed Valdis M, Chu MWA, Schlachta C, Kiaii B (2016) Evaluation of robotic cardiac surgery simulation training: a randomized controlled trial. J Thorac Cardiovasc Surg 151:1498-1505.e2CrossRefPubMed
8.
go back to reference Tam V, Zenati M, Novak S, Chen Y, Zureikat AH, Zeh HJ 3rd, Hogg ME (2017) Robotic pancreatoduodenectomy biotissue curriculum has validity and improves technical performance for surgical oncology fellows. J Surg Educ 74:1057–1065CrossRefPubMed Tam V, Zenati M, Novak S, Chen Y, Zureikat AH, Zeh HJ 3rd, Hogg ME (2017) Robotic pancreatoduodenectomy biotissue curriculum has validity and improves technical performance for surgical oncology fellows. J Surg Educ 74:1057–1065CrossRefPubMed
9.
go back to reference Chen R, Rodrigues Armijo P, Krause C, Robotic Task Force SAGES, Siu K-C, Oleynikov D (2020) A comprehensive review of robotic surgery curriculum and training for residents, fellows, and postgraduate surgical education. Surg Endosc 34:361–367CrossRefPubMed Chen R, Rodrigues Armijo P, Krause C, Robotic Task Force SAGES, Siu K-C, Oleynikov D (2020) A comprehensive review of robotic surgery curriculum and training for residents, fellows, and postgraduate surgical education. Surg Endosc 34:361–367CrossRefPubMed
10.
go back to reference Moglia A, Ferrari V, Morelli L, Ferrari M, Mosca F, Cuschieri A (2016) A systematic review of virtual reality simulators for robot-assisted surgery. Eur Urol 69:1065–1080CrossRefPubMed Moglia A, Ferrari V, Morelli L, Ferrari M, Mosca F, Cuschieri A (2016) A systematic review of virtual reality simulators for robot-assisted surgery. Eur Urol 69:1065–1080CrossRefPubMed
11.
go back to reference Satava RM, Stefanidis D, Levy JS, Smith R, Martin JR, Monfared S, Timsina LR, Darzi AW, Moglia A, Brand TC, Dorin RP, Dumon KR, Francone TD, Georgiou E, Goh AC, Marcet JE, Martino MA, Sudan R, Vale J, Gallagher AG (2020) Proving the effectiveness of the fundamentals of robotic surgery (FRS) skills curriculum: a single-blinded, multispecialty, multi-institutional randomized control trial. Ann Surg 272:384–392CrossRefPubMed Satava RM, Stefanidis D, Levy JS, Smith R, Martin JR, Monfared S, Timsina LR, Darzi AW, Moglia A, Brand TC, Dorin RP, Dumon KR, Francone TD, Georgiou E, Goh AC, Marcet JE, Martino MA, Sudan R, Vale J, Gallagher AG (2020) Proving the effectiveness of the fundamentals of robotic surgery (FRS) skills curriculum: a single-blinded, multispecialty, multi-institutional randomized control trial. Ann Surg 272:384–392CrossRefPubMed
12.
go back to reference Aghazadeh MA, Jayaratna IS, Hung AJ, Pan MM, Desai MM, Gill IS, Goh AC (2015) External validation of global evaluative assessment of robotic skills (GEARS). Surg Endosc 29:3261–3266CrossRefPubMed Aghazadeh MA, Jayaratna IS, Hung AJ, Pan MM, Desai MM, Gill IS, Goh AC (2015) External validation of global evaluative assessment of robotic skills (GEARS). Surg Endosc 29:3261–3266CrossRefPubMed
13.
go back to reference Farivar BS, Flannagan M, Michael Leitman I (2015) General surgery residents’ perception of robot-assisted procedures during surgical training. J Surg Educ 72:235–242CrossRefPubMed Farivar BS, Flannagan M, Michael Leitman I (2015) General surgery residents’ perception of robot-assisted procedures during surgical training. J Surg Educ 72:235–242CrossRefPubMed
14.
go back to reference Mark Knab L, Zenati MS, Khodakov A, Rice M, Al-Abbas A, Bartlett DL, Zureikat AH, Zeh HJ, Hogg ME (2018) Evolution of a Novel Robotic Training Curriculum in a Complex General Surgical Oncology Fellowship. Ann Surg Oncol 25(12):3445–3452 Mark Knab L, Zenati MS, Khodakov A, Rice M, Al-Abbas A, Bartlett DL, Zureikat AH, Zeh HJ, Hogg ME (2018) Evolution of a Novel Robotic Training Curriculum in a Complex General Surgical Oncology Fellowship. Ann Surg Oncol 25(12):3445–3452
15.
go back to reference Thomaschewski M, Esnaashari H, Höfer A, Renner L, Benecke C, Zimmermann M, Keck T, Laubert T (2019) Video tutorials increase precision in minimally invasive surgery training—a prospective randomised trial and follow-up study. Zentralbl Chirur 144:153–162CrossRef Thomaschewski M, Esnaashari H, Höfer A, Renner L, Benecke C, Zimmermann M, Keck T, Laubert T (2019) Video tutorials increase precision in minimally invasive surgery training—a prospective randomised trial and follow-up study. Zentralbl Chirur 144:153–162CrossRef
16.
go back to reference Mota P, Carvalho N, Carvalho-Dias E, João Costa M, Correia-Pinto J, Lima E (2018) Video-based surgical learning: improving trainee education and preparation for surgery. J Surg Educ 75:828–835CrossRefPubMed Mota P, Carvalho N, Carvalho-Dias E, João Costa M, Correia-Pinto J, Lima E (2018) Video-based surgical learning: improving trainee education and preparation for surgery. J Surg Educ 75:828–835CrossRefPubMed
17.
go back to reference Pape-Koehler C, Immenroth M, Sauerland S, Lefering R, Lindlohr C, Toaspern J, Heiss M (2013) Multimedia-based training on Internet platforms improves surgical performance: a randomized controlled trial. Surg Endosc 27:1737–1747CrossRefPubMedPubMedCentral Pape-Koehler C, Immenroth M, Sauerland S, Lefering R, Lindlohr C, Toaspern J, Heiss M (2013) Multimedia-based training on Internet platforms improves surgical performance: a randomized controlled trial. Surg Endosc 27:1737–1747CrossRefPubMedPubMedCentral
18.
go back to reference Halim J, Jelley J, Zhang N, Ornstein M, Patel B (2021) The effect of verbal feedback, video feedback, and self-assessment on laparoscopic intracorporeal suturing skills in novices: a randomized trial. Surg Endosc 35:3787–3795CrossRefPubMed Halim J, Jelley J, Zhang N, Ornstein M, Patel B (2021) The effect of verbal feedback, video feedback, and self-assessment on laparoscopic intracorporeal suturing skills in novices: a randomized trial. Surg Endosc 35:3787–3795CrossRefPubMed
19.
go back to reference Snyder CW, Vandromme MJ, Tyra SL, Hawn MT (2009) Proficiency-based laparoscopic and endoscopic training with virtual reality simulators: a comparison of proctored and independent approaches. J Surg Educ 66:201–207CrossRefPubMed Snyder CW, Vandromme MJ, Tyra SL, Hawn MT (2009) Proficiency-based laparoscopic and endoscopic training with virtual reality simulators: a comparison of proctored and independent approaches. J Surg Educ 66:201–207CrossRefPubMed
20.
go back to reference Al-Jundi W, Elsharif M, Anderson M, Chan P, Beard J, Nawaz S (2017) A randomized controlled trial to compare e-feedback versus “standard” face-to-face verbal feedback to improve the acquisition of procedural skill. J Surg Educ 74:390–397CrossRefPubMed Al-Jundi W, Elsharif M, Anderson M, Chan P, Beard J, Nawaz S (2017) A randomized controlled trial to compare e-feedback versus “standard” face-to-face verbal feedback to improve the acquisition of procedural skill. J Surg Educ 74:390–397CrossRefPubMed
21.
go back to reference Thinggaard E, Kleif J, Bjerrum F, Strandbygaard J, Gögenur I, Matthew Ritter E, Konge L (2016) Off-site training of laparoscopic skills, a scoping review using a thematic analysis. Surg Endosc 30:4733–4741CrossRefPubMed Thinggaard E, Kleif J, Bjerrum F, Strandbygaard J, Gögenur I, Matthew Ritter E, Konge L (2016) Off-site training of laparoscopic skills, a scoping review using a thematic analysis. Surg Endosc 30:4733–4741CrossRefPubMed
22.
go back to reference Madan AK, Harper JL, Taddeucci RJ, Tichansky DS (2008) Goal-directed laparoscopic training leads to better laparoscopic skill acquisition. Surgery 144:345–350CrossRefPubMed Madan AK, Harper JL, Taddeucci RJ, Tichansky DS (2008) Goal-directed laparoscopic training leads to better laparoscopic skill acquisition. Surgery 144:345–350CrossRefPubMed
23.
go back to reference Stefanidis D, Acker CE, Greene FL (2010) Performance goals on simulators boost resident motivation and skills laboratory attendance. J Surg Educ 67:66–70CrossRefPubMed Stefanidis D, Acker CE, Greene FL (2010) Performance goals on simulators boost resident motivation and skills laboratory attendance. J Surg Educ 67:66–70CrossRefPubMed
24.
go back to reference Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM (2010) Fundamentals of Laparoscopic Surgery simulator training to proficiency improves laparoscopic performance in the operating room—a randomized controlled trial. Am J Surg 199:115–120CrossRefPubMed Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM (2010) Fundamentals of Laparoscopic Surgery simulator training to proficiency improves laparoscopic performance in the operating room—a randomized controlled trial. Am J Surg 199:115–120CrossRefPubMed
25.
go back to reference Thomaschewski M, Laubert T, Zimmermann M, Esnaashari H, Vonthein R, Keck T, Benecke C (2020) Efficacy of goal-directed minimally invasive surgery simulation training with the Lübeck Toolbox-Curriculum prior to first operations on patients: Study protocol for a multi-centre randomized controlled validation trial (NOVICE). Int J Surg Protoc 21:13–20CrossRefPubMedPubMedCentral Thomaschewski M, Laubert T, Zimmermann M, Esnaashari H, Vonthein R, Keck T, Benecke C (2020) Efficacy of goal-directed minimally invasive surgery simulation training with the Lübeck Toolbox-Curriculum prior to first operations on patients: Study protocol for a multi-centre randomized controlled validation trial (NOVICE). Int J Surg Protoc 21:13–20CrossRefPubMedPubMedCentral
Metadata
Title
Conception and prospective multicentric validation of a Robotic Surgery Training Curriculum (RoSTraC) for surgical residents: from simulation via laboratory training to integration into the operation room
Authors
Michael Thomaschewski
Markus Kist
Markus Zimmermann
Claudia Benecke
Jörg C. Kalff
Colin M. Krüger
Benno Mann
Andreas Türler
Tobias Keck
Richard Hummel
Publication date
01-12-2024
Publisher
Springer London
Published in
Journal of Robotic Surgery / Issue 1/2024
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI
https://doi.org/10.1007/s11701-023-01813-6

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