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Implementation of robotic rectal surgery training programme: importance of standardisation and structured training
Sofoklis Panteleimonitis1,2, Sotirios Popeskou3, Mohamed Aradaib4
1Poole Hospital NHS Trust, Longfleet Road, Poole, BH15 2JB, UK. sofoklis_p@hotmail.com.
Langenbeck'S Archives of Surgery
|June 22, 2018
Summary
A structured training pathway enables surgeons to safely adopt robotic rectal cancer surgery using the da Vinci Xi system. Ten supervised cases were sufficient for independent robotic rectal resection, demonstrating good short-term outcomes.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Robotic Surgery
Background:
- Robotic rectal cancer surgery requires structured training for safe adoption.
- Single-docking technique with da Vinci Xi and integrated table motion (ITM) is being explored.
Purpose of the Study:
- To describe the training pathway for robotic rectal cancer surgery.
- To evaluate short-term surgical outcomes of surgeons trained in single-docking robotic rectal surgery.
Main Methods:
- Prospective analysis of 82 patients undergoing robotic rectal cancer resection (Nov 2015-Sep 2017).
- Comparison of short-term outcomes between supervised (first 10 cases) and independent (subsequent) cases per surgeon.
- Analysis of Global Assessment Score (GAS) and CUSUM charts to assess training progression.
Main Results:
- No conversions, anastomotic leaks, or 30-day mortality observed.
- Mean operative time was shorter in independent cases (275 min) vs. supervised (311 min) (p=0.038).
- Ten proctoring cases were adequate for independent robotic rectal resection using da Vinci Xi.
Conclusions:
- A structured training pathway and standardized technique make single-docking robotic rectal surgery with da Vinci Xi a valid and reproducible approach.
- The technique offers good short-term outcomes for the studied patient population.
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