Robotics
Unique to Sinai, we have developed a robotic surgery curriculum designed to take residents from novice to independent console surgeon. The robotic surgery curriculum is intended to provide residents with the skills necessary to become practicing, credentialed robotic surgeons in general surgery through an integrated approach of simulation-based learning modules, practical labs, operative experience, didactic teaching and case log system.
The course targets all six core competencies and provides graduated responsibility to the residents. Starting with online modules, the residents learn about how the pieces of the da Vinci Surgical System interact and how to troubleshoot problems. The dry labs are intended to begin the hands-on robotics experience. The residents are introduced to robotic procedure, including how to position the robot, where to place ports, how to dock and undock and how to insert and exchange instruments.
During this phase of the curriculum, residents are expected to view at least two robotic procedures in their entirety, focusing on the actions of the bedside assistant. Once the case observations are completed and the initial dry lab skills are mastered, the resident may then function in the capacity of a bedside assist with a seasoned assistant. After double scrubbing on three cases successfully, the resident will then be credentialed to be an independent bedside assistant.
After residents complete this first phase of training (by the end of PGY-2), they may then begin training as a console surgeon. Simulation modules that address needle control and needle driving, suturing and knot tying, energy and dissection, and camera control and clutching must be mastered with a passing score of 80 percent. New dry labs will focus on applying these skills to the actual robot. Once the above steps are successfully completed, the resident will be allowed to perform portions of the case as the console surgeon (PGY-3 and 4).
In their final year of residency, individuals are eligible to work towards becoming independent console surgeons. Prerequisites include successful completion of all of the training phases listed above, as well as participating as a console surgeon in at least 15 cases. The resident should create a plan of care for review by the attending. Discussion of possible complications and long-term care must be reviewed and understood thoroughly. At this point the resident will be given the opportunity to perform the majority of the case under the supervision of the attending physician. Successful completion of five cases allows the resident to obtain a letter from the program director asserting that the resident is safe and proficient in robotic surgery and should be considered for independent credentials after graduation.