4.3 Review

Training residents in robotic thoracic surgery

Journal

JOURNAL OF THORACIC DISEASE
Volume 13, Issue 10, Pages 6169-6178

Publisher

AME PUBL CO
DOI: 10.21037/jtd-2019-rts-06

Keywords

Robotic surgery; residency training

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The need for structured training in robotic technology for thoracic surgery is increasing, but there is currently no standard curriculum for residents. Multiple training programs are in development, incorporating simulation technology and gradual increase in responsibilities within operations. Surgeons practicing robotic surgery need to make efforts to further the training of residents, but a perfect and suitable program has not been identified yet.
With growing integration of robotic technology in thoracic surgery, the need for structured training has never been greater with trainees expressing desire for additional experience. Determining the ideal education program is challenging as the collective experience is still relatively early and growing with many experienced surgeons still becoming facile with the platform. Understanding differences between robotic and thoracoscopic approaches including lung retraction and dissection, use of carbon dioxide insufflation, and lack of tactile feedback serves as the foundation for building a skillset. Currently, there is no standard accepted curriculum for residents. Inclusion of these trainees in structured programs has been shown to be safe with equivalent patient outcomes. There are multiple curricula under development, all of which incorporate use of simulation technology, dual console, and clear, graduated responsibilities within operations. These include introduction to the robotic system prior to progressing to bedside assistance and finally to time as console surgeon. The importance of clear definition of training milestones with deliberate graduation to more complex tasks once competency has been demonstrated cannot be overstated. It is crucial for surgeons practicing robotic surgery to make efforts to further the training of residents, but there has not been any perfect and suitable program identified yet.

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