Teaching und Training in der robotergestützten Chirurgie

Zusammenfassung

Robotergestützte Operationsmethoden haben die minimalinvasive Chirurgie nachhaltig beeinflusst und werden auch in Zukunft ihren Stellenwert einfordern. In der Folge sind strukturierte Trainingsprogramme essenziell, um Chirurgen für den Operationssaal der Zukunft bestmöglich vorzubereiten. Eine Anlehnung an Programme aus dem Bereich der Aviatik scheinen hierbei sinnvoll und können die Ausbildung mit speziellem Augenmerk auf Effektivität, Effizienz sowie Patientensicherheit nachhaltig beeinflussen. In diesem Zusammenhang konnten simulationsgestützte Ausbildungskonzepte und OP-Workshops bereits ihre Sicherheit sowie positive Kosteneffektivität fachübergreifend aufzeigen. Proctoring und sog. Flying-Doctor-Modelle sind weitere wichtige Konzepte vor allem in der fortgeschrittenen Weiterbildung. Dieser Artikel gibt eine Übersicht der aktuellen Entwicklungen zum Thema Training und Teaching in der robotergestützten Chirurgie und möge als Grundlage für eine kontroverse Diskussion dienen.

Abstract

The development and proliferation of robot-assisted surgery has greatly extended the field of minimally invasive surgery. Thus, this necessitates the development of adequate training programs to prepare surgeons for the operating room of the future. Transferring established and proven methods of training and assessment in aviation could help robotic training programs become more effective, efficient and safer. Simulation is a safe and cost-effective way of training and in addition may improve operating room performance. Proctoring and flying doctor models are established concepts, especially for advanced training. This review summarises current developments in robotic surgical training and teaching and may help to start a controversial discussion.

Schlüsselwörter

robotergestützte Chirurgie - minimalinvasive Chirurgie - laparoskopische Chirurgie - Teaching - Training

Key words

robot-assisted surgery - minimally invasive surgery - laparoscopic surgery - teaching - training

• Literatur

• 1 Carpenter BT, Sundaram CP. Training the next generation of surgeons in robotic surgery. Robot Surg 2017; 4: 39-44
• 2 Moit H, Dwyer A, De Sutter M. et al. A standardized robotic training curriculum in a general surgery program. JSLS 2019; 23: e2019.00045
• 3 Raad WN, Ayub A, Huang CY. et al. Robotic thoracic surgery training for residency programs: a position paper for an educational curriculum. Innovations (Phila) 2018; 13: 417-422
• 4 Zylka-Menhorn V. Roboterassistierte Chirurgie: Kostenintensiv – bei eher dünner Evidenzlage. Dtsch Arztebl 2019; 116: A-1278/B-1053/C-1041
• 5 Beckmann JH. Roboter-assistierte bariatrische Chirurgie in Deutschland. Chir Allg Ztg 2019; 20: 294-298
• 6 Pernar LIM, Robertson FC, Tavakkoli A. et al. An appraisal of the learning curve in robotic general surgery. Surg Endosc 2017; 31: 4583-4596
• 7 Guilbaud T, Birnbaum DJ, Berdah S. et al. Learning curve in laparoscopic liver resection, educational value of simulation and training programmes: a systematic review. World J Surg 2019; 43: 2710-2719
• 8 Crawford DL, Dwyer AM. Evolution and literature review of robotic general surgery resident training 2002–2018. Updates Surg 2018; 70: 363-368
• 9 Collins JW, Wisz P. Training in robotic surgery, replicating the airline industry. How far have we come?. World J Urol 2019; DOI: 10.1007/s00345-019-02976-4.
• 10 Brook NR, DellʼOglio P, Barod R. et al. Comprehensive training in robotic surgery. Curr Opin Urol 2019; 29: 1-9
• 11 Smith R, Patel V, Satava R. Fundamentals of robotic surgery: a course of basic robotic surgery skills based upon a 14-society consensus template of outcomes measures and curriculum development. Int J Med Robot 2014; 10: 379
• 12 Satava RM, Stefanidis D, Levy JS. et al. Proving the effectiveness of the fundamentals of robotic surgery (FRS) skills curriculum: a single-blinded, multispecialty, multi-institutional randomized control trial. Ann Surg 2019; DOI: 10.1097/SLA.0000000000003220.
• 13 Volpe A, Ahmed K, Dasgupta P. et al. Pilot validation study of the European Association of Urology robotic training curriculum. Eur Urol 2015; 68: 292-299
• 14 Foell K, Finelli A, Yasufuku K. et al. Robotic surgery basic skills training: evaluation of a pilot multidisciplinary simulation-based curriculum. Can Urol Assoc J 2013; 7: 430-434
• 15 Dulan G, Rege RV, Hogg DC. et al. Developing a comprehensive, proficiency-based training program for robotic surgery. Surgery 2012; 152: 477-488
• 16 Dulan G, Rege RV, Hogg DC. et al. Content and face validity of a comprehensive robotic skills training program for general surgery, urology, and gynecology. Am J Surg 2012; 203: 535-539
• 17 Collins JW, Levy J, Stefanidis D. et al. Utilising the Delphi process to develop a proficiency-based progression train-the-trainer course for robotic surgery training. Eur Urol 2019; 75: 775-785
• 18 Kwon EO, Bautista TC, Blumberg JM. et al. Rapid implementation of a robot-assisted prostatectomy program in a large health maintenance organization setting. J Endourol 2010; 24: 461-465
• 19 Ericsson KA, Delaney PF. Long-term working Memory as an Alternative to Capacity Models of working Memory in everyday skilled Performance. In: Miyake A, Shah P. eds. Models of working Memory: Mechanisms of active Maintenance and executive Control. Cambridge: Cambridge University Press; 1999: 257-297