Development of a European Consensus in Robotic Training for Gastrointestinal Surgery Trainees
Idea for the project
In 2014, EAES released a consensus statement on the use of robotics in general surgery. However, at the time, the training, assessment and certification process for robotic surgery had not been thoroughly evaluated due to its relative infancy and the acceptance of robotics within the surgical community was uncertain. In recent years, there has been an increasing adoption of robotic surgery in centres across Europe. However, there is currently no consensus among societies and surgical specialty boards regarding the training and certification for gastrointestinal (GI) trainees in robotic surgery.
To evaluate the need for our study, we performed a snapshot survey amongst surgical colleagues receiving 104 responses from 17 different countries and members of 48 international societies. Only 14% of trainees said they have a dedicated robotic training curriculum and over 70% of trainees do not have access to robotic training lists, fellowships or courses. Forty-four percent of trainees stated that they have no access to robotic training with trainees having to travel as far as 50 miles to reach their nearest robotic simulator. Overall, 90% of trainees in our survey stated that robotic training needs improving and a dedicated training curriculum is essential.
Therefore, the aim of our study is to develop a consensus in robotic training for GI trainees across Europe through the EAES society. We will achieve this through these five key steps. In Step 1, a Steering Committee, consisting of our sandpit group, EAES committee members and trainees, has been established to lead and coordinate the consensus development process. In Step 2, a systematic review will identify the elements that are essential to a robotic training curriculum. In Step 3, a validated branching survey will be disseminated to EAES members and industry, which will inform our position statements. In Step 4, a Delphi process will be performed to reach consensus amongst the Steering Committee and a broader Delphi panel of a wide range of experts, trainees, industry and patient representatives. In Step 5, the developed consensus will be disseminated via the official journal of EAES (Surgical Endoscopy), international presentations and social media.
A European consensus in GI robotic training will define and standardise the essential elements and content of a curriculum for GI trainees, such as minimum requirements, clinical proctorship programmes and competency-based assessments. This will help to streamline training and steepen the learning curve for GI trainees, which will ultimately lead to an improvement in patient care and safety.
Experience of the sandpit day:
We all very much enjoyed the day of the EAES Research Sandpit. The programme allowed us to share research ideas by working with other team members, establish new collaborations and build on our clinical and academic profile within surgery. The day also provided us with a unique opportunity to be mentored by members of the EAES Committees who are eminent surgical academics. Overall, it was a great educational and inspirational experience which we would highly recommend to future participants.
SMartglasses Application for Remote Training in General LAparoScopic Surgery (SMARTGLASS): A Multi-Centre Pilot Study
Idea of the project
Laparoscopic surgery is associated with improved patient outcomes compared to an open approach for many operations. However, access to laparoscopic colectomy and hernia repair is as low as 14%-53% in Europe. Efforts have been made to enhance access to laparoscopic surgery training, but geographical distance limits the proctoring component of these programs.
Remote proctoring is a potential solution. Smartglasses technology connects an operating surgeon to a remote proctor who communicates with the operating surgeon while seeing a live feed through the operating surgeon’s lenses. The proctor can support the surgeon through real-time communication and the use of annotation using augmented reality technology. Prior studies have demonstrated that Smartglasses technology can be safely in the operating theatre with remote proctors in different institutions, and in some cases, even separate countries.
The aim of this pilot study is to assess the feasibility of applying Smartglasses technology to support qualified operating surgeons in gaining proficiency with laparoscopic colectomy and laparoscopic hernia repair using real-time remote proctoring. Operating surgeons will be evaluated with the use of validated assessment tools and will gain access to coaching from leading surgical experts in North America and Europe.
The overarching goal is to establish a foundation on which to build a program with the mission of democratizing access to laparoscopic surgery. This program would include a structured approach to supporting practicing surgeons in transitioning from open surgery to laparoscopy by providing them with unparalleled access to mentorship by surgical experts around the world to enhance patient care.
Our team is sincerely grateful for the EAES Research Sandpit in enabling us to build robust academic relationships and even stronger friendships. We benefited from high-level discussions among group members as well as other Sandpit colleagues and gained invaluable input from expert mentors. As trainees, we represent the next generation of surgeons. The Sandpit program gave us a unique platform to establish a unique professional network as we grow together as colleagues over the next few decades. We strongly encourage future surgical trainees to join this movement.
Moving forward, we invite practicing surgeons and fellows to join our program and gain proficiency in performing laparoscopic colectomy and/or laparoscopic hernia repair. Participation in this program will provide a unique opportunity to further refine surgical skills to apply in practice, while access to mentorship from international surgical experts will be lifelong.