Training, Credentialing, Proctoring and Medicolegal Risks of Robotic Urological Surgery: Recommendations of the Society of Urologic Robotic Surgeons

Zorn, Kevin C.; Gautam, Gagan; Shalhav, Arieh L.; Clayman, Ralph V.; Ahlering, Thomas E.; Albala, David; Lee, David I.; Sundaram, Chandru P.; Matin, Surena F.; Castle, Erik P.; Winfield, Howard N.; Gettman, Matthew T.; Lee, Benjamin R.; Thomas, Raju; Patel, Vipul; Leveillee, Raymond J.; Wong, Carson; Badlani, Gopal H.; Rha, Koon Ho; Eggener, Scott E.; Wiklund, Peter; Mottrie, Alexandre; Atug, Fatih; Kural, Ali Rıza; Joseph, Jean

doi:10.1016/j.juro.2009.05.042

Cited by 184 publications

(125 citation statements)

References 27 publications

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“…[40][41][42] Similar challenges are now being recognized during the adoption of the robotic platform in surgical oncology. 41 Although industry offers basic training for robotic surgery, the benefits of these programs appear to diminish over time. 43 More vigorous training has been shown to expedite the learning process, transfer technical skill at a higher rate, and lead to higher retention over the longterm.…”

Section: Discussionmentioning

confidence: 91%

Population‐level comparative effectiveness of laparoscopic versus open radical nephrectomy for patients with kidney cancer

Tan

Wolf

et al. 2011

Cancer

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BACKGROUND:Because there is limited population-based evidence supporting the comparative effectiveness of laparoscopic radical nephrectomy (LRN) after its widespread adoption, we compared trends in hospital-based outcomes among patients with kidney cancer treated with LRN or open radical nephrectomy (ORN). METHODS: Using linked SEER-Medicare data, the authors identified patients with kidney cancer who were treated with LRN or ORN from 2000 through 2005. The authors measured 4 primary outcomes: intensive care unit (ICU) admission, prolonged length of stay, 30-day hospital readmission, and in-hospital mortality. The authors then estimated the association between surgical approach and each outcome, adjusting for patient demographics, tumor characteristics, and year of surgery. RESULTS: The authors identified 2108 (26%) and 5895 (74%) patients treated with LRN and ORN, respectively. Patients treated with LRN were more likely to be white, female, of higher socioeconomic position, and to have tumor sizes of 4 cm (all P < .05). The adjusted probability of ICU admission and prolonged length of stay was 41% and 46% lower, respectively, for patients undergoing LRN (P < .001). Although uncommon for both groups, the adjusted probability of in-hospital mortality was 51% higher (2.3% vs 1.5%, P ¼ .04) for patients treated with a laparoscopic approach. CONCLUSIONS: At a population level, patients treated with LRN have a lower likelihood of ICU admission and prolonged length of stay, supporting the convalescence benefits of laparoscopy. In-hospital mortality, however, was higher among patients treated with LRN. The latter finding suggests a potentially unanticipated consequence of this technique and highlights the need for long-term monitoring during and after the widespread adoption of new surgical technologies. Cancer 2011;117:4184-93.

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Section: Discussionmentioning

confidence: 91%

Population‐level comparative effectiveness of laparoscopic versus open radical nephrectomy for patients with kidney cancer

Tan

Wolf

et al. 2011

Cancer

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“…In fact, published guidelines for the safe introduction of RARP at an institution are surprisingly absent. 3 Currently, the US Food and Drug Administration (FDA) has in place a mandate that robotic companies are responsible for at least some of the training for a robotic surgeon. In a consensus document from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and the Minimally Invasive Robotic Association (MIRA) they set out the minimum standard to which surgeons should be trained.…”

Section: Setting Up a Successful Robotic Servicementioning

confidence: 99%

Overcoming the challenges of robot-assisted radical prostatectomy

Goldstraw¹,

Challacombe

Patil

et al. 2011

Prostate Cancer Prostatic Dis

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“…Rocha et al 11 reported that the methodology adopted in radical resection of the prostate (even with the surgeons in training), produced early results similar to groups that had already been established. In Europe and especially in the USA, robotic technology has been well developed since the early 2000s, where there are more than 1,300 surgical robots installed.…”

Section: Discussionmentioning

confidence: 82%

“…The objective of this agreement was to incorporate the experience acquired by that success group, minimizing complications, unnecessary costs and reaching the outlined objectives more quickly [8][9][10][11][12][13] . The profile of chosen surgeons took into account extensive experience in laparoscopic surgery and they were given freedom to choose the procedures.…”

Section: Discussionmentioning

confidence: 99%

“…In Europe and especially in the USA, robotic technology has been well developed since the early 2000s, where there are more than 1,300 surgical robots installed. Thus, the discussion about training and deployment of the robotic access route has already been made in the residency programs [11][12][13][16][17][18][19] . It is also important to note that not all types of surgeries performed during training have met the criteria found in the literature for the advantageous use of the robotic platform.…”

Section: Discussionmentioning

confidence: 99%

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Modelo de programa de treinamento em cirurgia robótica e resultados iniciais

Madureira

Varela

Filho

et al. 2017

Rev. Col. Bras. Cir.

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RESUMO Objetivo: descrever a implantação de um programa de treinamento em cirurgia robótica e apontar as operações em Cirurgia Geral que podem ser feitas com vantagens utilizando a plataforma robótica. Métodos: estudo prospectivo do Grupo de Cirurgia Robótica em Cirurgia Geral e Colorretal do Hospital Samaritano (Rio de Janeiro, Brasil), de outubro de 2012 a dezembro 2015. São descritas as etapas do treinamento e particularidades. Resultados: no período do estudo foram realizadas 293 operações robóticas em Cirurgia Geral: 108 cirurgias para obesidade mórbida, 59 colorretais, 55 cirurgias na área da transição esôfago-gástrica, 16 colecistectomias, 27 hérnias da parede abdominal, 13 hernioplastias inguinais, duas gastrectomias com linfadenectomia à D2, uma vagotomia, duas hernioplastias diafragmáticas, quatro cirurgias hepáticas, duas adrenalectomias, duas esplenectomias, uma pancreatectomia, uma anastomose biliodigestiva. O índice de complicações foi de 2,4% sem complicações maiores. Conclusão: o Programa de Cirurgia Robótica do Hospital Samaritano foi implementado de forma segura e com resultados iniciais acima da literatura. Parece haver benefício em se utilizar a plataforma robótica nos super obesos, nas reoperações de cirurgia de obesidade e de hérnias de hiato, hérnias de hiato gigantes e para-esofágicas, hérnias ventrais com múltiplos defeitos e ressecções baixas de reto.

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Training, Credentialing, Proctoring and Medicolegal Risks of Robotic Urological Surgery: Recommendations of the Society of Urologic Robotic Surgeons

Cited by 184 publications

References 27 publications

Population‐level comparative effectiveness of laparoscopic versus open radical nephrectomy for patients with kidney cancer

Population‐level comparative effectiveness of laparoscopic versus open radical nephrectomy for patients with kidney cancer

Overcoming the challenges of robot-assisted radical prostatectomy

Modelo de programa de treinamento em cirurgia robótica e resultados iniciais

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