Introductory TORS training in an otolaryngology residency program

Transoral robotic surgery (TORS) is becoming an integral part of the otolaryngology resident experience. While there is widespread agreement that a formal, validated curriculum for TORS training is needed for residents, none presently exists. The primary objective of this study is to evaluate an introductory resident curriculum for TORS training that could be easily adopted at other institutions. This is a prospective study of otolaryngology residents (PGY1-5) in an academic medical center from 2015 to 2016. Trainees completed an introductory TORS training program consisting of online modules, logistic training, and hands-on training consisting of 12 tasks on the da Vinci Skills Simulator (dVSS). The primary outcomes were completion of training and time to completion. The secondary outcomes included resident attitudes regarding TORS as reflected on post-training survey. A total of 20 resident trainees participated in the study. 85% of trainees completed the hands-on robotic training in the allotted 3-h time limit. The average time to completion for those who finished was 91.53 min (SD 33.59 min). There was no statistically significant correlation between time to completion and PGY, number of robotic first assists, or total number of robotic cases. An introductory, resident-directed TORS training curriculum using the dVSS on an active surgical console is feasible in an academic medical center and may contribute to basic robotic competency among residents. Institutions with a dVSS may replicate this training in a resource-efficient manner prior to implementation of more comprehensive training. Robotic skills are likely trainable and independent from surgical skills learned during residency.