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Incorporating Robotic-Assisted Surgery Training into Integrated Thoracic Surgery Residency Programs
Chyun-Yin Huang, Adnan M. Al-Ayoubi, Ahmad Al-Taweel, Adil Ayub, Khalid Alshehri, Sadiq Rehmani, Wissam Raad, Faiz Y. Bhora.
Mount Sinai Health System, New York, NY, USA.

OBJECTIVE: With increased usage of robotic techniques across surgical fields, there is a need for residents in Integrated Thoracic Surgery Residency Programs to have early exposure and familiarity with the robotic platform. Various curricula for robotic-assisted surgery have been published for general surgery but there are no standardized curricula for training residents in robotic-assisted thoracic surgery. We propose a curriculum that can be incorporated into I6 programs to increase resident competency.
METHODS: We surveyed all 24 Integrated Thoracic Surgery Program Directors in the United States and performed a PubMed search using the following keywords: “robotic surgery,” “robotic curriculum,” “robotic thoracic surgery,” and “resident education”. We reviewed various robotic surgery training curricula and evaluation tools currently being used in the training of general surgery residents. We then designed a framework adapted towards I6 residents based off our review and program directors’ survey consensus.
RESULTS: There is an increase in the interest for formal training in robotic assisted thoracic surgery. A suitable training curriculum is integrated during PGY2-6 years and is divided into preclinical (PGY2-3) and clinical (PGY4-6) stages (Table 1). In the preclinical stage, residents are required to complete introductory online modules, virtual reality (VR) and simulator training, as well as in-house workshops. During clinical stage, the resident will serve as a supervised bedside assistant (SBA) and progress to a console surgeon. Each case will have defined steps that the resident must demonstrate competency. Evaluation will be based on guidelines set by Global Evaluative Assessment of Robotic Skills (GEARS). For programs that do not meet robotic case volumes for resident training, we recommend collaboration with a high volume center performing robotic surgery.
CONCLUSIONS: Expansion and utilization of robotic assistance in thoracic surgery has increased. The proposed curriculum enables thoracic residents in integreated thoracic surgery residency programs to have increased exposure to robotic platform and to master basic skills required in robotic assisted thoracic surgeries.

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