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Monday, June 06, 2016

Robotic surgical training: Where are we?



abstract
June 2, 2016 
 
there is still no standardized curriculum

Highlights

Proficiency with robotic hysterectomy and lymphadenectomy occurs after the first 20–30 cases.
Mastery does not occur until much later.
The learning curve for robotic surgery is comparable between fellows and attending physicians.
Most robotic educational curriculums incorporate a didactic and a graduated hands-on experience.

Background and objective

Over the past 10 years, robotic surgery has revolutionized the advancement of MIS in gynecologic oncology. As the use of robotic surgery has increased, so has the interest in the surgical training of gynecologic oncology fellows. The purpose of this review is to summarize the state of robotic surgical education in Gynecologic Oncology.

Methods

Several electronic databases were searched to identify studies that discussed robotic surgical education in gynecologic oncology. Particular attention was given to articles that discussed educational curriculum. The various curriculums were compared and summarized.

Results

The first reports of robotic surgery curriculums in gynecologic oncology emerged in 2008.
Prior to that the early adapters had to rely on less structured curriculums that essentially used live animal models and cadaveric dissections on the robot to simulate live surgery. More recent surgical curriculums are more structured and include the same basic components: didactics and a graduated hands-on experience. There is also an accredited robotic educational curriculum, the Fundamentals of Robotic Surgery (FRS), which combine an on-line curriculum with dry lab and operating room components that can be scored using a validated assessment tool.

Conclusions

Robotic surgical education has come a long way in the decade that the robotic platform has been available in the U.S. Although there is still no standardized curriculum, most fellowship training programs in gynecologic oncology have fairly consistent training. Simulation training is another tool that can help a surgeon achieve proficiency quicker.

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