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Implementation of robotic rectal surgery training programme: importance of standardisation & structured training



Poole Hospital in the UK and the Champalimaud Foundation in Portugal publishes a paper on the safe adoption of robotic rectal surgery using the EARCS structured training programme



Today, the EARCS trained teams at Poole Hospital in the UK and Champalimaud Foundation in Portugal announced the publication of a new paper in Langenbeck's Archives of Surgery:

Panteleimonitis S, Popeskou S, Aradaib M, Harper M, Ahmed J, Ahmad M, Qureshi T, Figueiredo N, Parvaiz A (2018) Implementation of robotic rectal surgery training programme: importance of standardisation and structured training. Langenbeck's Archives of Surgery 403:749–760.

The manuscript describes the training pathway and short-term surgical outcomes of three surgeons in two centres (UK and Portugal) undertaking single-docking robotic rectal surgery with the da Vinci Xi and integrated table motion (ITM). 

Data from 82 patients was analysed. There were no conversions to open, no anastomotic leaks and no 30-day mortality. Mean operation time was 288 min (SD 63), median estimated blood loss 20 (IQR 20–20) ml and median length of stay 5 (IQR 4–8) days. Thirty-day readmission and reoperation rates were 4% (n = 3) and 6% (n = 5) respectively. When comparing the supervised cases with the subsequent solo cases, there were no statistically significant changes in any of the short-term outcomes with the exception of mean operative time, which was significantly shorter in the independent cases (311 vs 275 min, p = 0.038). GAS form analysis and GAS CUSUM charting revealed that ten proctoring cases were enough for trainee surgeons to independently perform robotic rectal resections with the da Vinci Xi.

Results show that by applying a structured training pathway and standardising the surgical technique, the single-docking procedure with the da Vinci Xi is a valid, reproducible technique that offers good short-term outcomes.

EARCS is very proud to have been part of this landmark paper showing that a structured training programme is essential for the safe adoption of robotic rectal cancer surgery. Congratulations to everyone involved in the study!