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[Methods for training of robot-assisted radical prostatectomy].

Abstract

Robotic surgery is a future method of minimal invasive surgery. Robot-assisted radical prostatectomy (RARP) is a common method of surgical treatment of prostate cancer. Due to significant differences of the surgical technique of RARP compared to open or laparoscopic radical prostatectomy (LRP) new methods of training are needed. At the moment there are many opinions how to train physicians best. Which model is the most effective one remains nowadays controversial.

OBJECTIVE

Analyze currently available data of training methods of RARP. Determine the most effective training model and evaluate its advantages and disadvantages. Establish a standardized plan and criteria for proper training and certification of the entire surgical team.

MATERIAL AND METHODS

Literature review based on PubMed database, Web of Science and Scopus by keywords: robot-assisted radical prostatectomy, training of robot-assisted prostatectomy, training in robot-assisted operations, a learning curve of robot-assisted prostatectomy, virtual reality simulators (VR-simulators) in surgery.

RESULTS

According to the literature in average 18 to 45 procedures are required for a surgeon to achieve the plateau of the learning curve of the RARP. Parallel training, pre-operative warm-up and the use of virtual reality simulators (VR-simulators) can significantly increase the learning curve. There are many described models of RARP training.

CONCLUSIONS

The absence of accepted criteria of evaluation of the learning curve does not allow to use this parameter as a guide for the surgeon's experience. Proper training of robotic surgeons is necessary and requires new methods of training. There are different types of training programs. In our opinion the most effective training program is when a surgeon observes the performance of tasks or any steps of operation on the VR-simulator, then he performs them and analyzes mistakes by video recording. Then the surgeon observes real operations and performs some steps of the operation which are already leant on the simulator under supervision of the mentor and analyzes mistakes by video recording. Thus, mastering first the simple stages under supervision of a mentor, the surgeon effectively adopts the surgical experience from him. It is necessary to train not only the surgeons but also the entire surgical team.

Authors+Show Affiliations

Research Institute of Uronephrology and Human Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.University clinic of Urology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.University clinic of Urology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.Research Institute of Uronephrology and Human Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.University clinic of Urology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.University clinic of Urology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.University clinic of Urology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.Research Institute of Uronephrology and Human Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.University clinic of Urology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.University clinic of Urology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

Pub Type(s)

Journal Article
Review

Language

rus

PubMed ID

30789615

Citation

Rapoport, L M., et al. "[Methods for Training of Robot-assisted Radical Prostatectomy]." Khirurgiia, 2019, pp. 89-94.
Rapoport LM, Bezrukov EA, Tsarichenko DG, et al. [Methods for training of robot-assisted radical prostatectomy]. Khirurgiia (Mosk). 2019.
Rapoport, L. M., Bezrukov, E. A., Tsarichenko, D. G., Martirosyan, G. A., Sukhanov, R. B., Krupinov, G. E., Slusarenco, R. I., Morozov, A. O., Avakyan, S. K., & Sargsyan, N. A. (2019). [Methods for training of robot-assisted radical prostatectomy]. Khirurgiia, (1), 89-94. https://doi.org/10.17116/hirurgia201901189
Rapoport LM, et al. [Methods for Training of Robot-assisted Radical Prostatectomy]. Khirurgiia (Mosk). 2019;(1)89-94. PubMed PMID: 30789615.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Methods for training of robot-assisted radical prostatectomy]. AU - Rapoport,L M, AU - Bezrukov,E A, AU - Tsarichenko,D G, AU - Martirosyan,G A, AU - Sukhanov,R B, AU - Krupinov,G E, AU - Slusarenco,R I, AU - Morozov,A O, AU - Avakyan,S K, AU - Sargsyan,N A, PY - 2019/2/22/entrez PY - 2019/2/23/pubmed PY - 2019/5/31/medline KW - a learning curve of robot-assisted prostatectomy KW - robot-assisted radical prostatectomy KW - training in robot-assisted operations KW - training of robot-assisted prostatectomy KW - virtual reality simulators (VR-simulators) in surgery SP - 89 EP - 94 JF - Khirurgiia JO - Khirurgiia (Mosk) IS - 1 N2 - : Robotic surgery is a future method of minimal invasive surgery. Robot-assisted radical prostatectomy (RARP) is a common method of surgical treatment of prostate cancer. Due to significant differences of the surgical technique of RARP compared to open or laparoscopic radical prostatectomy (LRP) new methods of training are needed. At the moment there are many opinions how to train physicians best. Which model is the most effective one remains nowadays controversial. OBJECTIVE: Analyze currently available data of training methods of RARP. Determine the most effective training model and evaluate its advantages and disadvantages. Establish a standardized plan and criteria for proper training and certification of the entire surgical team. MATERIAL AND METHODS: Literature review based on PubMed database, Web of Science and Scopus by keywords: robot-assisted radical prostatectomy, training of robot-assisted prostatectomy, training in robot-assisted operations, a learning curve of robot-assisted prostatectomy, virtual reality simulators (VR-simulators) in surgery. RESULTS: According to the literature in average 18 to 45 procedures are required for a surgeon to achieve the plateau of the learning curve of the RARP. Parallel training, pre-operative warm-up and the use of virtual reality simulators (VR-simulators) can significantly increase the learning curve. There are many described models of RARP training. CONCLUSIONS: The absence of accepted criteria of evaluation of the learning curve does not allow to use this parameter as a guide for the surgeon's experience. Proper training of robotic surgeons is necessary and requires new methods of training. There are different types of training programs. In our opinion the most effective training program is when a surgeon observes the performance of tasks or any steps of operation on the VR-simulator, then he performs them and analyzes mistakes by video recording. Then the surgeon observes real operations and performs some steps of the operation which are already leant on the simulator under supervision of the mentor and analyzes mistakes by video recording. Thus, mastering first the simple stages under supervision of a mentor, the surgeon effectively adopts the surgical experience from him. It is necessary to train not only the surgeons but also the entire surgical team. SN - 0023-1207 UR - https://www.unboundmedicine.com/medline/citation/30789615/[Methods_for_training_of_robot_assisted_radical_prostatectomy]_ L2 - https://doi.org/10.17116/hirurgia201901189 DB - PRIME DP - Unbound Medicine ER -