Committee Opinion No. 674: Guiding Principles for Privileging of Innovative Procedures in Gynecologic Surgery

doi:10.1097/aog.0000000000001646

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…Voraussetzung aufseiten des Proctors ist eine große operative Expertise, eine gute Beobachtungsgabe, soziale Kompetenz und eine langjährige Erfahrung. Die Society of Gynecologic Surgeons empfiehlt eine kontinuierliche Qualitätssicherung für Roboterchirurgen, um eine sichere Patientenversorgung zu gewährleisten, und das American College of Obstetricians and Gynecologists empfiehlt, dass sich ein Chirurg einem Proctoring unterzieht, um seine Kompetenz zu schulen und zu überprüfen, bevor eine entsprechend neue Technik angewandt werden darf [18,19] [21]. So können auch auf internationaler Ebene kosten-und zeitneutral neue Fähigkeiten geschult bzw.…”

Section: Proctoring In Der Chirurgieunclassified

Der Stellenwert des Feedbacks beim Proctoring in der robotergestützten Chirurgie – ein Grundstein des Erfolgskonzeptes?

Alkatout

Maass

2023

Zentralbl Chir

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ZusammenfassungRoboterassistierte Operationsmethoden stellen eine Weiterentwicklung und Ergänzung der konventionellen Laparoskopie dar. Somit ist eine entsprechende Ausbildung der Chirurgen in diesem Fachgebiet unabdingbar. Gerade für die Anfangsphase eignen sich Simulationsprogramme – ähnlich wie in der Aviatik – hervorragend, um an das technisch herausfordernde Operationsverfahren heranzuführen. Im weiteren Verlauf, aber noch zu Beginn der Lernkurve, hat sich das Proctoring bewährt, um den zu trainierenden Chirurgen vor Ort zu begleiten, individuell zu schulen und an komplexere Fälle heranzuführen. Ein wesentlicher Baustein erfolgreicher Trainingskonzepte stellt das Feedback dar: Mit etwas zeitlichem Abstand und schriftlich fixiert erhält der zu schulende Chirurg eine Zusammenfassung bzw. einen Leitfaden, der sowohl die bestehende Situation als auch Verbesserungsvorschläge und das Zukunftspotenzial darlegt. Die Umsetzung eines solchen Feedbacks ermöglicht es dem Chirurgen, zusätzlich zur Anzahl an absolvierten Fällen, seine Selbsteinschätzung zu relativieren und Entwicklungsziele anzupassen. Somit stellt das Feedback die entscheidende Schnittstelle zwischen dem Beginn einer Lernkurve und fortgeschrittenen operativen Fähigkeiten inklusive der Möglichkeit einer realistischen Selbsteinschätzung dar.

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Section: Proctoring In Der Chirurgieunclassified

Der Stellenwert des Feedbacks beim Proctoring in der robotergestützten Chirurgie – ein Grundstein des Erfolgskonzeptes?

Alkatout

Maass

2023

Zentralbl Chir

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“…Surgical proctoring by expert surgeons allows hospitals to link credentialing to a standardized quality of surgical care across multiple sites [3]. The Society for Gynecologic Surgeons recommends ongoing quality assurance for robotic surgeons to ensure safe patient care and the American College of Obstetricians and Gynecologists recommends that a surgeon undergo proctoring to ensure competency before being granted privileges for new technology [4,5]. In addition, proctoring should allow for assessment of the surgical team, environment, and ability to troubleshoot technical failures.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, proctoring should allow for assessment of the surgical team, environment, and ability to troubleshoot technical failures. This proctoring should be done by someone who has already proven to be competent in the new procedure or technology [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Surgeon satisfaction and outcomes of tele-proctoring for robotic gynecologic surgery

2021

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Surgical proctoring requires increasing resources in growing healthcare systems. In addition, travel has become less safe in the era of COVID-19. This study demonstrates surgeon satisfaction and safety with tele-proctoring in robotic gynecologic surgery. This pilot study assesses surgeon satisfaction and operative outcomes with a novel operative tele-proctoring system with a continuous two-way video-audio feed that allows the off-site surgeon to see the operating room, surgical field, and hands of the robotic surgeon. After thorough system testing, two experienced surgeons underwent tele-proctoring for hospital credentialing, completing 7 total cases. Each completed pre-and post-surveys developed from the Michigan Standard Simulation Experience Scale. Surgical characteristics were compared between tele-proctored cases and 59 historical cases proctored in-person over the last 8 years. Surgeons reported unanimous high satisfaction with tele-proctoring (5 ± 0). There were no major technologic issues. Five of the tele-proctored cases and 35 of controls were hysterectomies. Mean age was 48.2 ± 1.4 years, mean BMI was 29.6 ± 0.9 kg/m 2 , and mean uterine weight was 152 ± 112.3 g. Two-thirds had prior abdominal surgery (P > 0.1). Tele-proctored hysterectomies were 58 ± 6.5 min shorter than controls (P = 0.001). There were no differences in EBL or complication rates (P > 0.1). Tele-proctoring resulted in high surgeon satisfaction rates with no difference in EBL or complications. Tele-mentoring is a natural extension of tele-proctoring that could provide advanced surgical expertise far beyond where we can physically reach.

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Residents’ Confidence in Performing Robotic Hysterectomy in Obstetrics and Gynecologic Training Programs

Gressel

George

Woodland

et al. 2021

Journal of Minimally Invasive Gynecology

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Study Objective: To compare residents' perceptions of readiness to perform robotic-assisted laparoscopic hysterectomy with the perceptions of residency program directors in obstetrics and gynecology programs throughout the United States. Design: A survey was administered to all residents taking the 2019 Council on Resident Education in Obstetrics and Gynecology Exam and concurrently to program directors in all Accreditation Council for Graduate Medical Education−accredited training programs. Setting: The survey was designed to assess resident confidence to perform robotic hysterectomies by the time of graduation. Patients: No patients were included in the study. Interventions: The only intervention was administration of the survey. Measurements and Main Results: De-identified survey data were analyzed using chi-squared and Fisher's exact tests. A total of 5473 resident respondents and 241 residency program directors were included in the study. Fifty-two percent of graduating residents reported that they felt they were given surgical autonomy to perform robotic hysterectomies, and 53.7% reported that they could perform one independently (if it was an "emergency" and they had to). By the time of graduation, only 59% of residents reported confidence performing a robotic hysterectomy, and only 56% reported they felt that it would be an important procedure for their future career. Program directors were significantly more likely to report that their residents were given autonomy to perform robotic hysterectomy by graduation (61.0% [95% confidence interval (CI), 54.3 −67.3]), could perform a robotic hysterectomy independently (60.9% [95% CI, 53.9−67.6]), or could perform a robotic hysterectomy by graduation (70.2% [95% CI, 63.5−76.3]) than residents themselves (38.6% [95% CI, 37.2−40.0], 22.8% [95% CI, 21.6−24.0], 62.6% [95% CI, 61.2−64.0], respectively). Conclusion: At the time of graduation, residents' confidence in performing robotic hysterectomy independently is lower than their confidence in performing all other approaches to hysterectomy.

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Committee Opinion No. 674: Guiding Principles for Privileging of Innovative Procedures in Gynecologic Surgery

Cited by 5 publications

References 6 publications

Der Stellenwert des Feedbacks beim Proctoring in der robotergestützten Chirurgie – ein Grundstein des Erfolgskonzeptes?

Der Stellenwert des Feedbacks beim Proctoring in der robotergestützten Chirurgie – ein Grundstein des Erfolgskonzeptes?

Surgeon satisfaction and outcomes of tele-proctoring for robotic gynecologic surgery

Residents’ Confidence in Performing Robotic Hysterectomy in Obstetrics and Gynecologic Training Programs

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