Immersive robotic colorectal training in the United Kingdom is safe and efficient

With increased utilisation of robotics in surgery, the demand for structured training is increasing. This paper presents the safety and efficacy profile of a robotic colorectal fellowship in the United Kingdom.

This is a retrospective study conducted in a district general hospital between 2019 and 2023. Procedures performed using the Da Vinci robot were divided into two cohorts, those performed by robotic fellows and those performed by consultant surgeons. Each fellowship lasted on average six months and at the end of the fellowship the trainee had completed the mandatory requirements to be certified as a robotic surgeon. The objective of this study is to compare the outcomes of procedures performed by the fellows with those performed by consultants.

Of the 224 robotic procedures recorded, 117 were performed by consultants and 107 by fellows. The median time to complete the procedure was 315min vs 257min for consultants and fellows, respectively. The average postoperative length of stay was 6 and 7 days, the anastomotic leak rate was 4.3% and 5.6% and reoperation rate was 11% and 9% for procedures performed by consultants and fellows, respectively. The median lymph nodal yield was 17 in both groups and the margin positivity rate (R1) resection rate was 7% and 4% (p = 0.4) for procedures performed by consultants and fellows.

It is possible to safely train in robotic colorectal surgery without compromising patient safety, oncological outcomes or adversely affecting theatre efficiency.