Training for next generation surgeons: a pilot study of robot-assisted hysterectomy managed by resident using dual console

Arch Gynecol Obstet. 2021 Apr;303(4):981-986. doi: 10.1007/s00404-020-05870-2. Epub 2020 Nov 12.

Abstract

Purpose: To assess feasibility of a standardized robot-assisted hysterectomy managed by resident and supervised by senior surgeon using dual-console on a 21-step grid (max score = 42) assessing resident autonomy.

Methods: A total of seven patients managed between September 2019 and March 2020 by six residents in gynecology and obstetrics were included. Standardized robot-assisted hysterectomy for endometrial cancer or adenomyosis was performed.

Results: No conversion to laparotomy, no intra- or post-operative incidents were reported. Mean score on the evaluation scale was 29.8 out of 42 (SD = 7.3). Mean operative time was 104 min (SD = 23). Mean average suturing time was, respectively, 335 s (SD = 57 s) and 270 s (SD = 53 s) for the first and the fourth knot. There was a 65 s improvement between the first and the fourth intracorporeal knot (p = 0.043). The perceived workload evaluated with the NASA TLX score showed a low level of stress (Temporal demand = 1.6 /10), and a low level of frustration (Frustration level = 3.6/10). Experience gained during the surgery was felt to be important (Commitment = 8.6/10).

Conclusion: Standardized robot-assisted hysterectomy managed by a resident supervised by a senior surgeon using the dual-console seems feasible. This tool could be useful to assess residents' surgical skills.

Keywords: Dual-console; Hysterectomy; Resident; Robotic surgery; Surgical education.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Clinical Competence*
  • Female
  • France
  • Gynecology / education*
  • Humans
  • Hysterectomy / education*
  • Internship and Residency*
  • Laparoscopy / education
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Robotic Surgical Procedures / education*