Table 1 Summary of the curriculum standards with their mean score given in final (Round 4) of training Delphi
Standards | Mean | Standard Deviation |
|---|---|---|
Module 1: Core skills for First assistant (medical) These competencies are proposed as a curriculum for the first assistant in robotic surgery. The individual undertaking this module is assumed to have skills and experience in straight-stick laparoscopic and open surgery. | ||
Knowledge of the operative room setup of the robotic system | 4.65 | 0.47 |
Be able to drape the robotic system | 4.00 | 0.91 |
Be able to position a patient for surgery and have a knowledge of ergonomic positioning | 4.69 | 0.46 |
Be able to perform the vaginal phase preparation | 4.27 | 0.65 |
Have an understanding of the role and different types of uterine manipulation | 4.00 | 0.96 |
Perform safe entry of trocars and port placement | 4.48 | 0.69 |
Demonstrate understanding of the rationale for site port placement | 4.42 | 0.56 |
Be able to dock the robotic system | 4.54 | 0.63 |
Be able to trouble shoot and re-dock the robotic system | 4.12 | 0.69 |
Be able to dock the robot in different positions | 4.08 | 0.79 |
Be able to maintain a clear image by cleaning/changing the camera | 4.75 | 0.43 |
Be able to insert, change and remove robotic instruments | 4.77 | 0.42 |
Be able to adjust the arm positions to improve clearance or resolve clashing | 4.46 | 0.63 |
Be able to appropriately use the assistant port | 4.73 | 0.52 |
Be able to undock the robotic system | 4.77 | 0.42 |
Be able to perform an emergency undocking procedure | 4.77 | 0.42 |
Module 2: Core skills for Console surgeon It is assumed that the individual undertaking this module should be experienced in gynaecology with in-depth knowledge of abdominal/pelvic anatomy, be able to care for surgically unwell patients and appropriately manage intra-operative complications e.g. bowel/bladder injuries. It is assumed that the individual is able to perform the intended procedure by open surgery. | ||
Completion of the online robotic system theoretical training package | 4.69 | 0.60 |
Awareness of the fundamentals of the robotic system components and instrumentation | 4.73 | 0.52 |
Awareness of other surgical routes/modalities, and the benefits/potential complications with robotic surgery | 4.69 | 0.53 |
Be able to adjust the surgical robot’s settings | 4.69 | 0.53 |
Knowledge of different docking positions and the indications | 4.88 | 0.31 |
Understanding of the use of electrodiathermy in robotic surgery and its potential complications | 4.96 | 0.19 |
Have undertaken simulation training on a robotic simulator/trainer | 4.19 | 1.07 |
Be able to turn on and calibrate the robotic system | 4.04 | 0.59 |
Completion of 15a cases of supervised training | 3.08b | 1.17 |
Be able to perform a final review of the operative set up | 4.38 | 0.78 |
Be able to respond to system errors | 4.73 | 0.52 |
Demonstrate camera control and set up visual field | 4.85 | 0.36 |
Demonstrate clutching of the robotic instruments | 4.85 | 0.36 |
Demonstrate multi-arm control of the robotic instruments | 4.81 | 0.39 |
Demonstrate hand-eye instrument coordination | 4.85 | 0.36 |
Demonstrate wrist articulation | 4.81 | 0.39 |
Demonstrate atraumatic tissue handling | 4.88 | 0.31 |
Maintain safety of operative field | 4.88 | 0.31 |
Demonstrate blunt dissection with the robotic system | 4.73 | 0.44 |
Demonstrate micro-dissection with the robotic system | 4.46 | 0.57 |
Demonstrate safe tissue cutting with the robotic system | 4.85 | 0.36 |
Demonstrate needle driving with the robotic system | 4.81 | 0.48 |
Demonstrate suture handling with the robotic system | 4.85 | 0.36 |
Demonstrate knot tying with the robotic system | 4.77 | 0.42 |
Demonstrate continuous suturing with the robotic system | 4.73 | 0.44 |
Have undertaken case observation of experienced surgeons performing robotic cases | 4.42 | 0.74 |
Module 3: Commitment to continued surgical development These requirements have been proposed for surgeons who have completed their training in robotic surgery. | ||
Prospective audit of all robotic cases | 4.46 | 0.57 |
Demonstrate analysis and reflection of complications associated with robotic surgery | 4.62 | 0.56 |
Perform a minimum 25c robotic cases per year | 4.19 | 1.14 |
Attend emergency drill training with the robotic surgery team annually | 4.31 | 0.72 |