Having taken an extended break from writing about the problems associated with robotic surgery, I think it’s time to explore an area not previously discussed.
What is the effect of the robot on surgical resident education?
|The robot at the OR table (babe not included).|
Let’s review a few points about robot-assisted surgery. The surgeon actually doing the case is not scrubbed. He sits at a console away from the patient and manipulates the instruments. Another doctor has to scrub and insert the instruments through small incisions and “dock” (connect the instruments) to the part of the robot that is next to the patient.
The assistant at the patient’s side views the operation on a video screen. Sources tell me that residents get to do a lot of docking, observing, inserting and removing instruments and closing incisions but not much time, if any, at the console doing the operation.
There is a dual console capability but many hospitals do not invest in it because of the added cost of the fully equipped second console.
|Two consoles. Resident (left) shown participating in the operation.|
So how are the residents going to learn to perform surgery? There is already evidence that they lack confidence in their ability to operate independently. See my earlier blog on this subject.
The majority of graduating chief residents in surgery take at least one year of fellowship training. One can only hope that they train in a hospital that has at least one dual-console robot or they may end up practicing on you and me.