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Is Robotic Console Time a Surrogate for Resident Operative Autonomy?

Theresa N Wang1, Ingrid A Woelfel1, Heidi Pieper1

  • 1Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

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|June 9, 2023
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Summary

Robotic console time (RCT) is a reliable indicator of resident operative autonomy in robotic surgery. This objective measure can enhance the assessment of surgical training efficiency and resident skill development.

Keywords:
console timeoperative autonomyresident autonomyresident educationrobotic surgery

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Area of Science:

  • Surgical Education
  • Minimally Invasive Surgery
  • Medical Technology Assessment

Background:

  • Robotic-assisted surgery is increasingly integrated into general surgery training curricula.
  • Quantifying resident autonomy on robotic platforms presents a challenge for objective assessment.
  • Robotic console time (RCT) is proposed as a potential metric for evaluating resident operative autonomy.

Purpose of the Study:

  • To characterize the correlation between objective resident robotic console time (RCT) and subjectively scored operative autonomy.
  • To assess the validity of RCT as a measure of resident autonomy in specific robotic procedures.

Main Methods:

  • Resident operative autonomy was rated using a validated instrument by residents and attending surgeons during robotic cholecystectomy and inguinal hernia repair.
  • Robotic console time (RCT) data was extracted from the Intuitive surgical system for matched cases.
  • Statistical analyses included descriptive statistics, t-tests, and ANOVA to compare groups and assess correlations.

Main Results:

  • A total of 31 robotic surgeries (13 cholecystectomies, 18 inguinal hernia repairs) were analyzed, involving 8 residents and 4 attending surgeons.
  • Average RCT was 35.6% for junior residents (PGY 2-3) and 59.7% for senior residents (PGY 4-5).
  • RCT significantly correlated with subjective autonomy evaluations (r=0.61, p=0.0003) and resident training level (r=0.5306, p<0.0001).

Conclusions:

  • Resident robotic console time (RCT) serves as a valid surrogate for assessing operative autonomy in robotic general surgery.
  • RCT offers a valuable objective measure for evaluating resident autonomy and training efficiency in robotic procedures.
  • Further research is recommended to correlate RCT with other objective and subjective autonomy metrics.