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Tahapary M, Timmerman S, Ledger A, Dewilde K, Froyman W. Implementation of robot-assisted myomectomy in a large university hospital: a retrospective descriptive study. Facts Views Vis Obgyn 2023; 15:243-250. [PMID: 37742201 PMCID: PMC10643016 DOI: 10.52054/fvvo.15.3.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Background Background: Myomectomy is often the preferred treatment for symptomatic patients with myomas who wish to preserve their fertility, with a shift from open surgery towards minimally invasive techniques. Objectives Retrospective study assessing patient and surgery characteristics, follow-up, and outcomes of robot-assisted myomectomy (RAM) and abdominal myomectomy (AM) in women treated between January 1, 2018, and February 28, 2022, in a Belgian tertiary care hospital. Materials and Methods A descriptive analysis was conducted on consecutive patients who underwent myomectomies. 2018 was considered the learning curve for RAM. Main outcome measures We assessed rate of open surgery, operation time, postoperative hospital stay, and operative complications. Results In total, 94 RAMs and 15 AMs were performed. The rate of AMs was 56.5% in 2018 versus 2.3% after the learning curve. The median operation time for RAM was 136.5 minutes and 131 minutes for AM. Conversion rate for RAM was 0%. The median postoperative hospital stay after RAM was 1 night and 4 nights for AM. Postoperative complication rate was low, with only 14.9% and 33.3% of patients requiring pharmacological treatment of complications after RAM or AM, respectively. No surgical re-intervention was needed in any group. Conclusions Implementation of RAM at our centre resulted in a significant reduction of open surgery rate. RAM demonstrated shorter hospital stays and a lower incidence of complications compared to AM. What is new? Our study highlights the successful adoption of RAM, showcasing its potential to replace AM even in complex cases. The findings affirm the safety and feasibility of RAM, supporting its use as a valuable technique for minimally invasive myomectomy.
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Song C, Jang TK, Kong S, Kang H, Kwon SH, Cho CH. Robotic Single-Site Radical Hysterectomy for Early Cervical Cancer: A Single Center Experience of 5 Years. J Pers Med 2023; 13:jpm13050733. [PMID: 37240903 DOI: 10.3390/jpm13050733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/18/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The mainstay of treatment for early-stage cervical cancer is surgery; we present a 5-year experience of robotic single-site radical hysterectomy (RSRH) focused on surgical and oncologic outcomes. METHODS This retrospective study included 44 cases of RSRH performed in patients with early-stage cervical cancer. RESULTS The median follow-up period for the 44 patients was 34 months. The mean total operation time was 156.07 ± 31.77 min, while mean console time was 95.81 ± 24.95 min. Two cases had complications, which required surgical management, while four cases (9.1%) exhibited recurrence. The disease-free survival rate at 5 years was 90.9%. The sub-division analysis showed that Stage Ia2 and stage Ib1 patient sub-group showed better DFS than that of the stage Ib2 patient sub-group. The learning curve analysis showed that the CUSUM-T initially peaks at the sixth case then gradually decreases before rising and peaking at the 24th case. After 24th case, the CUSUM-T gradually decreases and reaches zero. CONCLUSION The surgical outcomes of RSRH for early-stage cervical cancer treatment were safe and acceptable. However, RSRH could be considered carefully only in well-selected patient groups. Large-scale prospective studies are necessary in the future to validate the results.
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Affiliation(s)
- Changho Song
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Tae-Kyu Jang
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Soomin Kong
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Heeju Kang
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Sang-Hoon Kwon
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Chi-Heum Cho
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
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Alhusseinawi H, Haase R, Rasmussen S, Jensen JB, Kingo PS. Validation of a surgical workspace scale during robot-assisted surgery. Int J Med Robot 2023; 19:e2482. [PMID: 36403108 PMCID: PMC10078223 DOI: 10.1002/rcs.2482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/26/2022] [Accepted: 11/16/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND A sufficient surgical workspace is crucial to avoid complications. Within classic laparoscopy, many subjective surgical rating scales (SRSs) have previously been used to evaluate the surgical workspace. This study aimed to validate a modified version of the 5-point SRS during robot-assisted radical nephrectomy (RARN). METHODS Thirty-two intra-operative videos of intraperitoneal spaces were recorded from eight patients who underwent RARN. To attain the visualisation of different types of workspaces, we recorded 20 s panoramic videos of different pneumoperitoneum, namely 3, 5, 7 and 12 mmHg. The videos were randomised and presented two times to eight experienced robotic surgeons to evaluate the workspace using our modified 5-point SRS. Both inter-and intra-rater reliabilities were tested. RESULTS The results of the validation study showed moderate inter-rater and good to excellent intra-rater reliability. CONCLUSION This is a valid tool that can be confidently used by future researchers in the field of robot-assisted surgery.
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Affiliation(s)
- Hayder Alhusseinawi
- Department of Urology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Rikke Haase
- Department of Urology, Aalborg University Hospital, Aalborg, Denmark
| | - Sten Rasmussen
- Department of Urology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jørgen B Jensen
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Pernille S Kingo
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Dhanasingh A, Swords C, Bance M, Van Rompaey V, Van de Heyning P. Corrigendum: Cochlear Size Assessment Predicts Scala Tympani Volume and Electrode Insertion Force- Implications in Robotic Assisted Cochlear Implant Surgery. Front Surg 2021; 8:789184. [PMID: 34778368 PMCID: PMC8579103 DOI: 10.3389/fsurg.2021.789184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Anandhan Dhanasingh
- Research and Development Department, MED-EL, Innsbruck, Austria.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Chloe Swords
- Department of Physiology, Development and Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Manohar Bance
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Vincent Van Rompaey
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Paul Van de Heyning
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
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Dhanasingh A, Swords C, Bance M, Van Rompaey V, Van de Heyning P. Cochlear Size Assessment Predicts Scala Tympani Volume and Electrode Insertion Force- Implications in Robotic Assisted Cochlear Implant Surgery. Front Surg 2021; 8:723897. [PMID: 34660676 PMCID: PMC8514755 DOI: 10.3389/fsurg.2021.723897] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives: The primary aim was to measure the volume of the scala tympani (ST) and the length of the straight portion of the cochlear basal turn from micro-computed tomography (μCT) images. The secondary aim was to estimate the electrode insertion force based on cochlear size and insertion speed. Both of these objectives have a direct clinical relevance in robotic assisted cochlear implant (CI) surgery. Methods: The ST was segmented in thirty μCT datasets to create a three-dimensional (3D) model and calculate the ST volume. The diameter (A-value), the width (B-value), and the straight portion of the cochlear basal turn (S-value) were measured from the oblique coronal plane. Electrode insertion force was measured in ST models of two different sizes, by inserting FLEX24 (24 mm) and FLEX28 (28 mm) electrode arrays at five different speeds (0.1, 0.5, 1, 2, and 4 mm/s). Results: The mean A-, B-, and S-values measured from the 30 μCT datasets were 9.0 ± 0.5, 6.7 ± 0.4, and 6.9 mm ± 0.5, respectively. The mean ST volume was 34.2 μl ± 7 (range 23–50 μl). The ST volume increased linearly with an increase in A- and B-values (Pearson's coefficient r = 0.55 and 0.56, respectively). The A-value exhibited linear positive correlation with the B-value and S-value (Pearson's coefficient r = 0.64 and r = 0.66, respectively). In the smaller of the two ST models, insertion forces were higher across the range of insertion speeds during both array insertions, when compared to the upscaled model. Before the maximum electrode insertion depths, a trend toward lower insertion force for lower insertion speed and vice-versa was observed. Conclusion: It is important to determine pre-operative cochlear size as this seems to have an effect upon electrode insertion forces. Higher insertion forces were seen in a smaller sized ST model across two electrode array lengths, as compared to an upscaled larger model. The ST volume, which cannot be visualized on clinical CT, correlates with clinical cochlear parameters. This enabled the creation of an equation capable of predicting ST volume utilizing A- and B-values, thus enabling pre-operative prediction of ST volume.
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Affiliation(s)
- Anandhan Dhanasingh
- Research and Development Department, MED-EL, Innsbruck, Austria.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Chloe Swords
- Department of Physiology, Development and Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Manohar Bance
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Vincent Van Rompaey
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Paul Van de Heyning
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
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6
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Blazek A, Plambeck B, Lele S, Hill BC. Robot-Assisted Laparoscopic Removal of a Large Primary Retroperitoneal Mature Cystic Teratoma in an Adult. Cureus 2021; 13:e16329. [PMID: 34277308 PMCID: PMC8275068 DOI: 10.7759/cureus.16329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 11/06/2022] Open
Abstract
Mature teratomas are unique and generally benign neoplasms. They are derived from embryonic tissues and typically located within the gonadal region. Primary retroperitoneal teratomas are uncommon in adults and often challenging to treat, given their location and size. Here, we offer a rare case of a large primary retroperitoneal mature cystic teratoma, detected on abdominal ultrasound during the work-up of abdominal bloating and nausea and treated with robot-assisted laparoscopic excision in a 58-year-old male. In this report, we sought to describe the evaluation, treatment, and follow-up of this condition, as well as review the associated literature.
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Affiliation(s)
- Andrew Blazek
- Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, USA
| | - Benjamin Plambeck
- Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, USA
| | - Subodh Lele
- Department of Pathology, University of Nebraska Medical Center, Omaha, USA
| | - Brett C Hill
- Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, USA
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7
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Xu C, Wang Y, Zhou C, Zhang Z, Xie L, Andersson K, Feng L. Application research of master-slave cranio-maxillofacial surgical robot based on force feedback. Proc Inst Mech Eng H 2021; 235:583-596. [PMID: 33645309 DOI: 10.1177/0954411921997568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The complex anatomical structure, limited field of vision, and easily damaged nerves, blood vessels, and other anatomical structures are the main challenges of a cranio-maxillofacial (CMF) plastic surgical robot. Bearing these characteristics and challenges in mind, this paper presents the design of a master-slave surgical robot system with a force feedback function to improve the accuracy and safety of CMF surgery. METHODS A master-slave CMF surgical robot system based on force feedback is built with the master tactile robot and compact slave robot developed in the laboratory. Model-based master robot gravity compensation and force feedback mechanism is used for the surgical robot. Control strategies based on position increment control and ratio control are adopted. Aiming at the typical mandibular osteotomy in CMF surgery, a scheme suitable for robot-assisted mandibular osteotomy is proposed. The accuracy and force feedback function of the robot system under direct control and master-slave motion modes are verified by experiments. RESULTS The drilling experiment of the mandible model in direct control mode shows that the average entrance point error is 1.37 ± 0.30 mm, the average exit point error is 1.30 ± 0.25 mm, and the average posture error is 2.27° ± 0.69°. The trajectory tracking and in vitro experiment in the master-slave motion mode show that the average position following error is 0.68 mm, and the maximum force following error is 0.586 N, achieving a good tracking and force feedback function. CONCLUSION The experimental results show that the designed master-slave CMF robot can assist the surgeon in completing accurate mandibular osteotomy surgery. Through force feedback mechanism, it can improve the interaction between the surgeon and the robot, and complete tactile trajectory movements.
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Affiliation(s)
- Cheng Xu
- Institute of Forming Technology and Equipment, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Wang
- Department of Machine Design, KTH, Stockholm, Sweden
| | - Chaozheng Zhou
- Institute of Forming Technology and Equipment, Shanghai Jiao Tong University, Shanghai, China
| | - Zhenfeng Zhang
- Institute of Forming Technology and Equipment, Shanghai Jiao Tong University, Shanghai, China
| | - Le Xie
- Institute of Forming Technology and Equipment, Shanghai Jiao Tong University, Shanghai, China.,Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China
| | | | - Lei Feng
- Department of Machine Design, KTH, Stockholm, Sweden
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8
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Beulens AJW, Namba HF, Brinkman WM, Meijer RP, Koldewijn EL, Hendrikx AJM, van Basten JP, van Merriënboer JJG, Van der Poel HG, Bangma C, Wagner C. Analysis of the video motion tracking system "Kinovea" to assess surgical movements during robot-assisted radical prostatectomy. Int J Med Robot 2020; 16:e2090. [PMID: 32034977 DOI: 10.1002/rcs.2090] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/16/2020] [Accepted: 02/03/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUNDS Robot-assisted surgery facilitated the possibility to evaluate the surgeon's skills by recording and evaluating the robot surgical images. The aim of this study was to investigate the possibility of using a computer programme (Kinovea) for objective assessment of surgical movements in previously recorded in existing robot-assisted radical prostatectomy (RARP) videos. METHODS Twelve entire RARP procedures were analysed by a trained researcher using the computer programme "Kinovea" to perform semi-automated assessment of surgical movements. RESULTS Data analysis showed Kinovea was on average able to automatically assess only 22% of the total surgical duration per video of the robot-assisted surgery. On average, it lasted 4 hours of continued monitoring by the researcher to assess one RARP using Kinovea. CONCLUSION Although we proved it is technically possible to use the Kinovea system in retrospective analysis of surgical movement in robot-assisted surgery, the acquired data do not give a comprehensive enough analysis of the video to be used in skills assessment.
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Affiliation(s)
- Alexander J W Beulens
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.,Department of Urology, Catharina Hospital, Eindhoven, The Netherlands
| | - Hanae F Namba
- Department of Urology, Catharina Hospital, Eindhoven, The Netherlands.,Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
| | - Willem M Brinkman
- Department of Oncological Urology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Richard P Meijer
- Department of Oncological Urology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Evert L Koldewijn
- Department of Urology, Catharina Hospital, Eindhoven, The Netherlands
| | | | | | | | - Henk G Van der Poel
- Department of Urology, Dutch Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Chris Bangma
- Department of Urology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Cordula Wagner
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
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Abstract
Background: Abdominal rectus diastasis is a condition where the abdominal muscles are separated by an abnormal distance due to widening of the linea alba causing the abdominal content to bulge. It is commonly acquired in pregnancies and with larger weight gains. Even though many patients suffer from the condition, treatment options are poorly investigated including the effect of physiotherapy and surgical treatment. The symptoms include pain and discomfort in the abdomen, musculoskeletal and urogynecological problems in addition to negative body image and impaired quality of life. The purpose of this review was to give an overview of treatment options for abdominal rectus diastasis. Results: The first treatment step is physiotherapy. However, evidence is lacking on which regimen to use and success rates are not stated. The next step is surgery, either open or laparoscopic, and both surgical approaches have high success rates. The surgical approach includes different plication techniques. The recurrence and complication rates are low, complications are minor, and repair improves low back pain, urinary incontinence, and quality of life. Robotic assisted surgery might become a possibility in the near future, but data are still lacking. Conclusions: Evidence on what conservatory treatment to use is sparse, and more research needs to be done. Both open and laparoscopic surgery have shown positive results. Innovative treatment by robotic assisted laparoscopic surgery has potential, however, more research needs to be done in this area as well. An international guideline for the treatment of rectus diastasis could be beneficial for patients and clinicians.
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Affiliation(s)
- Majken Lyhne Jessen
- Department of Surgery, Center for Perioperative Optimization, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
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Rusch P, Ind T, Kimmig R, Maggioni A, Ponce J, Zanagnolo V, Coronado PJ, Verguts J, Lambaudie E, Falconer H, Collins JW, Verheijen RHM. Recommendations for a standardised educational program in robot assisted gynaecological surgery: Consensus from the Society of European Robotic Gynaecological Surgery (SERGS). Facts Views Vis Obgyn 2019; 11:29-41. [PMID: 31695855 PMCID: PMC6822956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND The Society of European Robotic Gynaecological Surgery (SERGS) aims at developing a European consensus on core components of a curriculum for training and assessment in robot assisted gynaecological surgery. METHODS A Delphi process was initiated among a panel of 12 experts in robot assisted surgery invited through the SERGS. An online questionnaire survey was based on a literature search for standards in education in gynaecological robot assisted surgery. The survey was performed in three consecutive rounds to reach optimal consensus. The results of this survey were discussed by the panel and led to consensus recommendations on 39 issues, adhering to general principles of medical education. RESULTS On review there appeared to be no accredited training programs in Europe, and few in the USA. Recommendations for requirements of training centres, educational tools and assessment of proficiency varied widely. Stepwise and structured training together with validated assessment based on competencies rather than on volume emerged as prerequisites for adequate and safe learning. An appropriate educational environment and tools for training were defined. Although certification should be competence based, the panel recommended additional volume based criteria for both accreditation of training centres and certification of individual surgeons. CONCLUSIONS Consensus was reached on minimum criteria for training in robot assisted gynaecological surgery. To transfer results into clinical practice, experts recommended a curriculum and guidelines that have now been endorsed by SERGS to be used to establish training programmes for robot assisted surgery.
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Affiliation(s)
- P Rusch
- Department of Obstetrics and Gynaecology, University Hospital Duisburg-Essen; Hufelandstr. 55, 45147 Essen, Germany. .
| | - T Ind
- Department of Gynaecological Oncology, The Royal Marsden, London, UK;,St George’s University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London,
| | - R Kimmig
- Department of Obstetrics and Gynaecology, University Hospital Duisburg-Essen; Hufelandstr. 55, 45147 Essen, Germany. .
| | - A Maggioni
- Division of Gynaecology, European Institute of Oncology, Via Ripamonti, 435,
20141 Milano, Italy. .
| | - J Ponce
- Department of Gynaecological Oncology, Hospital Universitari de Bellvitge, c/ Feixa Llarga, sn, 08907 L’ Hospitalet de Llobregat. Barcelona, Spain.
| | - V Zanagnolo
- Division of Gynaecology, European Institute of Oncology, Via Ripamonti, 435,
20141 Milano, Italy. .
| | - PJ Coronado
- Department of Gynaecological Oncology, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Avda. de Séneca, 2, Ciudad Universitaria, 28040 Madrid, Spain.
| | - J Verguts
- Division of Gynaecology, European Institute of Oncology, Via Ripamonti, 435,
20141 Milano, Italy. . ;,Department of Obstetrics and Gynaecology, University Hospitals Leuven, 3000 Leuven, Belgium;,Department of
Obstetrics and Gynaecology, Jessa Hospital, 3500 Hasselt, Belgium,
| | - E Lambaudie
- Department of Gynaecologic Oncology, Centre de Lutte Contre le Cancer Oscar Lambret, 3 Rue Frédéric Combemale, 59000 Lille, France;,Aix Marseille Université, Site Timone, Timone 27, boulevard Jean Moulin, 13385 Marseille cedex 5, France.
| | - H Falconer
- Department of Women’s and Children’s Health, Division of Obstetrics and Gynecology, Karolinska Institutet/University Hospital, 171 76 Stockholm, Sweden.
| | - JW Collins
- Department of Urology, Karolinska University Hospital, Karolinska Universitetssjukhuset, Solna, D1:01 171 76 Stockholm, Sweden.
| | - RHM Verheijen
- Department of Gynaecological Oncology, UMCU Cancer Center,
University Medical Center, Utrecht, Netherlands.
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