Robotic Surgery Curriculum for CMHS Surgical Residents Ventura County Medical Center. Robotic Surgery Training Pathway

Transcription

1 Robotic Surgery Curriculum for CMHS Surgical Residents Ventura County Medical Center Robotic Surgery Training Pathway STEP ONE: Training Session (given by Intuitive Surgical Representative) Advantages/Disadvantages of Robotic Surgery Basic Components of the Robotic System Console (Camera and Instrument control) Docking/Undocking Insert/Exchange of Instruments Equipment Tray Operations that are appropriate for Robotic Surgery Patients that are appropriate for Robotic Surgery Safety issues unique to Robotic Surgery Create Logins for Console and Online site STEP TWO: Online Training Login at Training => Surgeons => Online Training Courses Complete online training modules davinci Xi System Overview Docking Advanced Surgeon Console Controls Safety Features Assessment (Save/Print certificate and turn in to Dr. Barry Sanchez) View video of Cholecystectomy and Hernia Repair STEP THREE: Simulator Modules Complete the Simulator Modules with > 85% score Endowrist Manipulation - Pegboard 1+2; Matchboard 1+2; Ring&Rail1 Camera Control - Camera Targeting 1 Energy & Dissection - Energy Switching 1 and Energy Dissection 1 Needle Driving - Needle Targeting and Suture Sponge 1 Suturing - Complete all 5 modules (no score available) STEP FOUR: At-Patient Training Bedside assistant in 10 robotic cases (OK to do concomitant to STEP 3) Docking, Instrument exchange Console surgeon experience with attending for 5 cases Perform some portion of the case with active guidance by attending

2 *Pig Lab UCLA or Sunnyvale HQ (optional) STEP FIVE: Robotic Surgery Case log Basic Cases Perform Cholecystectomy and/or Hernia Repair (5 cases minimum) **If > 30 days between cases, complete 2 hours simulation to refresh skills **OK to start STEP SIX before completing this step STEP SIX: Advanced Simulator Training Complete the Simulator Modules with > 85% score Endowrist Manipulation Matchboard 3; Ring & Rail 2 Camera Control - Camera Targeting 2 Energy & Dissection Energy Switching 2; Energy Dissection 3 Needle Driving Suture Sponge 2 STEP SEVEN: Robotic Surgery Case log Advanced Cases Perform the majority of at least two Advanced Cases (MUST complete STEP SIX first) i.e. Segmental Colectomy, Rectopexy, Adrenalectomy, Proctectomy, Gastric bypass, sleeve gastrectomy, hiatal hernia repair STEP EIGHT: Final Certification Basic and Advanced modules completed with >85% score Minimum 5 cases as console surgeon Minimum 5 cases docking robot Perform 5 cases as console surgeon that are formally reviewed and determined competent by the Director of Robotics at VCMC.

3 STEP THREE: Basic Simulator Training Module Completion Log While it is encouraged to explore all of the simulation exercises in the main directory, the following modules are required. To meet this requirement, you need to reach > 85% score for each. Please record your score below. Resident: Module Date Completed Score (%) Pegboard 1 Pegboard 2 Matchboard 1 Matchboard 2 Ring & Rail 1 Camera Control: Camera Targeting 1 Energy & Dissection: Energy Switching 1 Energy & Dissection: Energy Dissection 1 Needle Driving: Needle Targeting Needle Driving: Suture Sponge 1 Suturing Modules: N/A

4 STEP FOUR: At-Patient Bedside Assistant Case Log Please place stickers from the cases in which you were the bedside assistant and participated in the insertion of trocars, docking of the robot, and insertion/exchange of instruments. You need a minimum of three cases. Once you have completed your log, please turn it into Dr. Barry Sanchez. *This can be performed/completed while still completing STEP THREE Resident: Patient Sticker Date Attending Operation

5 STEP FOUR: Basic Console Training Completion Log Place stickers for a minimum of 5 cases in which you were at the console and performed a portion of the case. *You MUST complete STEP THREE before embarking on this training step Resident: Patient Sticker Date Attending Operation

6 STEP FIVE: Console Surgeon Case Log (Basic) Place stickers from a minimum of 5 cases in which you were the console surgeon and performed a significant portion of the case. Resident: Patient Sticker Date Attending Operation

7 STEP SIX: Advanced Simulator Training Module Completion Log To meet this requirement, you need to reach > 85% score for each. You can complete this step while completing STEP FIVE. Please record your score below. Resident: Module Date Completed Score (%) Matchboard 3 Ring & Rail 2 Camera Control: Camera Targeting 2 Energy & Dissection: Energy Switching 2 Energy & Dissection: Energy Dissection 3 Needle Driving: Suture Sponge 2

8 STEP SEVEN: Console Surgeon Case Log (Advanced) Place stickers from advanced robotic cases in which you were the console surgeon and performed a significant portion of the case. You MUST complete STEP SIX prior to embarking on this step. Resident: Patient Sticker Date Attending Operation

9 STEP EIGHT: Console Surgeon Competency Evaluation This form is for residents in their final year who have already performed at least 5 cases as the console surgeon. The evaluation is to be completed by the Director of Robotic Surgery. This case is in addition to those previous 5 cases. Patient Sticker Resident Date Operation Skill Demonstrates understanding of trocar placement and spacing Understands principles of docking and is able to dock in a timely fashion Uses camera appropriately and is able to focus the camera Demonstrates appropriate clutching and maintains hands in a comfortable workspace Demonstrates ability to use third arm and switch between instruments SAFTEY: Does not move instruments that are not in view SAFETY: Recognizes tissue response to assess grip strength and handles tissue appropriately Demonstrates ability to troubleshoot system and manage collisions Please comment on areas of strength: Competent More Practice Recommended Please comment on opportunities for improvement: The resident demonstrates competency on the robotic system. YES NO Attending Name Attending Signature