Is Robotic Console Time a Surrogate for Resident Operative Autonomy?

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.