Applying the Delphi process for development of a hepatopancreaticobiliary robotic surgery training curriculum
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and Other Interventional Techniques
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Applying the Delphi process for development of a hepatopancreaticobiliary robotic surgery training curriculum Yuman Fong1 · Joseph F. Buell2 · Justin Collins3 · John Martinie4 · Christiane Bruns5 · Allan Tsung6 · Pierre‑Alain Clavien7 · Ido Nachmany8 · Bjørn Edwin9 · Johann Pratschke10 · Evgeny Solomonov11 · Alfred Koenigsrainer12 · Pier Cristoforo Giulianotti13 Received: 21 April 2020 / Accepted: 21 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Robotic hepatopancreaticobiliary (HPB) procedures are performed worldwide and establishing processes for safe adoption of this technology is essential for patient benefit. We report results of the Delphi process to define and optimize robotic training procedures for HPB surgeons. Methods In 2019, a robotic HPB surgery panel with an interest in surgical training from the Americas and Europe was created and met. An e-consensus–finding exercise using the Delphi process was applied and consensus was defined as 80% agreement on each question. Iterations of anonymous voting continued over three rounds. Results Members agreed on several points: there was need for a standardized robotic training curriculum for HPB surgery that considers experience of surgeons and based on a robotic hepatectomy includes a common approach for “basic robotic skills” training (e-learning module, including hardware description, patient selection, port placement, docking, troubleshooting, fundamentals of robotic surgery, team training and efficiency, and emergencies) and an “advanced technical skills curriculum” (e-learning, including patient selection information, cognitive skills, and recommended operative equipment lists). A modular approach to index procedures should be used with video demonstrations, port placement for index procedure, troubleshooting, and emergency scenario management information. Inexperienced surgeons should undergo training in basic robotic skills and console proficiency, transitioning to full procedure training of e-learning (video demonstration, simulation training, case observation, and final evaluation). Experienced surgeons should undergo basic training when using a new system (e-learning, dry lab, and operating room (OR) team training, virtual reality modules, and wet lab; case observations were unnecessary for basic training) and should complete the advanced index procedural robotic curriculum with assessment by wet lab, case observation, and OR team training. Conclusions Optimization and standardization of training and education of HPB surgeons in robotic procedures was agreed upon. Results are being incorporated into future curriculum for education in robotic surgery. Keywords Consensus · E-learning · Robotic · HPB surgery · Surgical education · Virtual reality Liver and pancreatic procedures are considered some of the most complex performed by surgeons, hence liver and pancreatic resections have been only recently adapted to the minimally invasive appr
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