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Published on: February 7, 2025
Robotic Integration Without Laparoscopic Displacement: Protecting Basic Cases in Surgical Training
George S Ferzli1, Alexander H Vu1
1Department of General Surgery, NYU Grossman School of Medicine, New York, New York.
None:
Robotic surgery is now an essential part of general surgery practice and general surgery training. The educational risk is not robotic adoption itself but unmeasured substitution: the replacement of foundational laparoscopic experience in common operations before robotic proficiency can be defined, assessed, and entrusted. This Perspective argues for platform-balanced training in which robotics expands resident capability without consuming the basic laparoscopic case pool. The proposed framework: (1) separates operative logs by platform, role, and task; (2) protects junior laparoscopic experience in appendectomy, cholecystectomy, and hernia repair; (3) moves residents to console modules after documented basic laparoscopic competence; and (4) uses maintenance drills and dashboards to detect curricular displacement. For trainees, this is fairness. For programs, it is governance. For patients, it is safety.

