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Updated: Aug 17, 2025

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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Parallel, component training in robotic total mesorectal excision.

Deena Harji1, Nour Aldajani1, Thomas Cauvin1

  • 1Department of Digestive Surgery, Colorectal Unit, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France.

Journal of Robotic Surgery
|December 14, 2022
PubMed
Summary
This summary is machine-generated.

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A new component-based training curriculum for robotic total mesorectal excision (TME) surgery is feasible and safe. This parallel training approach effectively teaches multiple surgical trainees simultaneously, improving robotic skills and maintaining clinical outcomes.

Area of Science:

  • Surgical Oncology
  • Medical Education
  • Robotic Surgery

Background:

  • Robotic total mesorectal excision (TME) is increasingly adopted for rectal cancer treatment.
  • There is a growing need for effective training methods for novice robotic surgeons.
  • Component-based learning offers a structured approach to surgical skill acquisition.

Purpose of the Study:

  • To assess the feasibility of a structured, parallel, component-based training curriculum for robotic TME surgery.
  • To evaluate the impact of this training method on surgical trainees and fellows.
  • To determine if this approach can train multiple surgeons simultaneously without compromising outcomes.

Main Methods:

  • A prospective pilot study was conducted from January to May 2021.
Keywords:
Rectal cancerRobotic surgery training

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  • A parallel training pathway involved two trainees per robotic case, with components assigned by a trainer.
  • Robotic proficiency was assessed using the Global Evaluative Assessment of Robotic Skills (GEARS) and EARCS Global Assessment Score (GAS).

    • Main Results:

    • Three trainees performed 52 TME resections, with trainees completing key operation components.
    • GEARS scores significantly improved from a baseline mean of 17.3 to a final mean of 23.8 (p=0.003).
    • GAS scores showed incremental improvement across all trainees during assessments (p<0.001).

    Conclusions:

    • A parallel, component-based training approach for robotic TME surgery is safe and feasible.
    • This method enables simultaneous training of multiple surgeons with varying experience levels.
    • The training strategy effectively enhances robotic surgical skills while maintaining high-quality clinical outcomes.