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Study Finds Learning The Surgical Robot May Require Two Different Types Of Training

Medical Society Presents UCSF Research Showing Two Distinct Skills Need to Be Learned Simultaneously

San Francisco – July 3, 2017/Press Release/ – A UCSF study intended to measure how best to integrate residents into complex robotic technology resulted in an additional finding and necessary distinction: teaching robotics requires distinguishing between learning surgical skills and learning a surgical tool, and recognizing the challenges associated with learning both at the same time. These findings will be presented at the Society of Laparoendoscopic Surgery (SLS) annual meeting on September 6-9 2017, in San Francisco. The study could have broad implications for other medical technology.

“While some general surgeons are adding robotics to their scope of practice, others are skeptical because of the costs and the challenge of integrating trainees,” says Dr. Courtney Green, general surgery resident, University of California, San Francisco (UCSF). “How we train new surgeons using robotics should emphasize the adaptability of surgical technique because technology continues to alter the tools we use to perform it.  Additionally surgical educators must maximize learning efficiency because many other proficiencies are required in resident training.”

The study was conducted by a team at UCSF, including Dr. Kelly Mahuron, Dr. Hobart Harris, Dr. Patricia O’Sullivan, and led by Dr. Green, who found that not only is there no universal consensus on how best to integrate residents into robotic technology, but when introducing new technology to trainees there are two separate requisite skill sets that must be acquired simultaneously. Robotic devices continue to evolve and be utilized in surgical procedures, and they will continue to grow in use as they become less expensive.

“Visual cues and perceptual expertise are essential for surgical skill acquisition regardless of the technology being used,” says Dr. Rishindra Reddy, assistant professor of surgery, University of Michigan, who was not involved in the study.

“Therefore, teaching the residents robotic surgery requires awareness of both what can be learned from the image and from what is not in the visual field.”

There was emphasis on the simulation exercises outside of the operating room to learn the tool functions, and an emphasis on the dual console to teach intraoperative surgical technique.

This study took a qualitative approach, helping the researchers understand the themes and concepts medical professionals have held about robotic surgery and resident training. Inherently, qualitative approaches allow for the use of unique language and description of specific experiences. This allows for parallels to emerge from individuals’ experiences that may not have otherwise been clearly recognized. The questions included:

  • Tell me about your experience with robot (how long/what cases).
  • What are the biggest challenges?
  • Thoughts on trainees participating in robotic surgery?
  • What level of trainees do you work with?
  • What are some challenges you have faced with integrating residents?
  • What do you differently when you have residents in robotic cases?

The answers to these questions reinforced the belief that robotic surgery has introduced unique challenges to the surgical workflow. The study, which included 24 practicing surgeons throughout the United States, also found that there was a disagreement about when to expose new physicians to robotic surgery, but was positive about how the tool can allow students to learn surgery and how leaders in the field can teach with it.

“Use of robotics at training programs makes resident integration critical,” says Hobart Harris, chief of general surgery, UCSF. “And a universal standard is being called for in order to improve the readiness of residents using complex technology without compromising other components of training. This research is part of what’s important in figuring out how we are going to incorporate robotics successfully into resident training.”

The discovery that two different skill sets were involved was uncovered by reviewing the study participants’ personal struggles with resident integration.  Initial efforts to teach practicing surgeons robotic technology focused entirely on the components of the surgical tool (the robot).  This process cannot simply be replicated for trainees because they have not yet mastered the surgical technique component that is also required.  The importance of acquiring these components simultaneously makes the robotic training process in residency unique.

“For colorectal surgery the robot has been innovative and helpful,” says Dr. Hueylan Chern, colorectal surgeon at UCSF Medical Center.  “Some procedures can now be done in a much gentler way using robotic surgery.  But first we need to be better at training surgeons how to use it.  This new research helps get us there.”

About the Society of Laparoendoscopic Surgeons

The Society of Laparoendoscopic Surgeons was established as an educational, non-profit organization to help ensure the highest standards for the practice of laparoscopic, endoscopic, and minimally invasive surgery. The Society serves surgeons from various specialties and other health professionals who are interested in advancing their expertise in the diagnostic and therapeutic uses of Laparoendoscopic and minimally invasive surgical techniques. With an international membership of over 6,000 surgeons, the organization offers a unique approach to the study and education of minimally invasive surgery by bringing together different medical specialties that use the techniques and tools of minimally invasive surgery.

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