A narrative review and proposed framework for robotic surgical training in Urology for Southeast Asia (SEA): a...

Robotic surgery has revolutionized modern surgical practices, expanding across multiple specialties due to its precision, reduced invasiveness, and improved patient outcomes. Initially dominated by the da Vinci system, the field has recently seen an influx of new robotic platforms, presenting challenges in training and adaptation for surgeons and surgical teams. The transition to diverse robotic systems necessitates a structured educational framework to ensure competency across varying platforms. This article explores the evolving landscape of robotic surgery, emphasizing the need for a comprehensive training methodology. A qualitative analysis of expert and novice perspectives identified three key domains for robotic surgery education: (1) Foundational Competence, which includes platform-specific training, ergonomics, teamwork, and emergency protocols; (2) Surgical Competence, focusing on systematic procedural training and stepwise surgical execution; and (3) Task-Based Micro-Competence, addressing fundamental skills like hemostasis, lymph node dissection, vascular control, bowel mobilization, and robotic suturing. The framework highlights the importance of platform-specific technical skills, team dynamics, and cognitive ergonomics to enhance surgical efficiency and patient safety. Additionally, it underscores the necessity for standardized training methodologies adaptable to diverse robotic systems. The study advocates for incorporating simulation-based learning, modular training, and emergency drills into robotic surgery education to bridge the gap between traditional and robotic-assisted techniques. As robotic surgery continues to evolve, the proposed structured training approach ensures surgeons and surgical teams are equipped with the skills required to navigate various platforms, optimize patient outcomes, and advance the field of robotic-assisted surgery.