2018 Research Forum

First 100 robotic cases and implementation of a robotics curriculum in a general surgery residency

Presenter: Domenech Asbun MD Principal Investigator & Faculty Sponsor: Andrea Pakula MD FACS

Domenech Asbun MD 1 , Ruby Skinner MD FACS FCCP FCCM 2 , Andrea Pakula MD MPH FACS 3 1 Resident Physician R4 2 Chief, Division of Trauma; Director, Surgical ICU: Chair, Institutional Review Board 3 Associate Director Surgical Critical Care; Director MIS/Robotics and Bariatric Surgery

INTRODUCTION The use of robotic technology is rapidly increasing among general surgeons but is not being routinely taught in general surgery residency. We aimed to evaluate our first 100 robotic cases during which time we developed a curriculum incorporating residents. PURPOSE To evaluate our early experience with robotic surgery and evaluate outcomes related to implementing a residency curriculum with robotic surgery. METHOD The first 100 robotic cases performed at our institution from 2016-2017 by two surgeons were analyzed. A residency curriculum was developed after the first 6 months. It consisted of online modules offered by Intuitive Surgical resulting in certification, simulator training and hands on workshops for cannula placement, docking, instrument exchange, camera clutching and other introductory tasks. Patient demographics, type of procedure, resident involvement, total operative and console times, length of stay, comorbid conditions and complications were evaluated. RESULTS 66 females and 34 males comprised this series with an average age of 44 years ±12. The majority of patients, 71% had comorbidities, with a predominance of hypertension and diabetes. The bariatric patients had an average BMI of 48±10. Cholecystectomies and Inguinal hernias comprised the majority of cases. Residents were involved in the last six months and participated in 40% of cases. There were no differences in operative times in cases with residents involved in the majority of procedures. There were 3 complications; postoperative ileus, a gallbladder fossa hematoma and an enterotomy. There was one early conversion to open in a complex foregut case and there were no deaths. (Table 1) CONCLUSIONS The implementation of a robotic surgery program and resident curriculum was safe with similar outcomes related to operative times, complications and lengths of stay. As robotics continues to grow, residencies should have a curriculum incorporated. Further data is needed to determine residency learning curves between robotics and laparoscopy.

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