Loyola Medicine Finds Better Way to Guide and Assess Robotic-assisted Surgery Trainees

Loyola Medicine Finds Better Way to Guide and Assess Robotic-assisted Surgery Trainees

Loyola medical school physicians have come up with a better way for surgeons in training to report on the robot-assisted prostate cancer operations they perform.

These reports are important because seasoned physicians use them to help decide whether the trainees are accomplished enough to do surgeries on their own.

The institution, whose full name is the Loyola University Chicago Stritch School of Medicine, has dubbed the new surgery reporting system RoboLog. It has used it in 310 urologic robotic surgeries so far.

Loyola researchers wrote an article on the approach, called “Design and Implementation of a Robotic Surgery Training Experience Logging System,” for the Journal of Surgical Education.

A surgeon who does robot-assisted surgery uses a console with a 3D monitor and two joysticks to  control the robot’s movements. The approach allows a surgeon to perform an operation with precision.

But before surgeons can perform any operation, they must reach certain training milestones while working as residents. Most medical schools use the Accreditation Council for Graduate Medical Education’s logging system to evaluate trainees.

It registers whether a resident performs or assists in a robotic surgery. A shortcoming of the system is that it fails to account for variations in how much a resident participates on the console.

For instance, a resident who only participates in removing lymph nodes — which is just one part of a robotic prostate cancer surgery — gets the same credit as a resident who performs the entire surgery.

The Loyola physicians who created RoboLog weren’t happy about this method. They improved it, along with suggesting tweaks to the standardized training that residents receive and creating guidelines for determining surgeon competency.

The result is a web-based logging system that provides more information on how a resident is involved in a robotic surgery. It covers 11 common urologic robotic procedures. With each procedure there is a menu listing the key steps a resident must take while performing the surgery.

When operations are completed, trainees can review their performance, including how long it took them to get to key steps in the procedure.

“Widespread usage of a logging system with more insight into step-specific involvement is needed,” researchers said in a press release. “RoboLog fills this need.”  It “can be used to track robotic training progress and aid in development of a standardized curriculum,” the team added.

Two other medical schools have begun using RoboLog. Loyola plans to make it available to any program wanting to use it.

Robotic-assisted surgery has become the most common way to perform a prostate cancer operation. The trend has occurred despite no proof that it is the best method.

A study in the journal The Lancet Oncology concluded that there is not enough information to know how well prostate cancer patients who have robotic-assisted surgery do over the long term, compared with men who have non-robotic surgery. The article was titled “Effect of patient choice and hospital competition on service configuration and technology adoption within cancer surgery: a national, population-based study.

Research has suggested that robotic-assisted surgery does reduce bleeding, scarring, and the length of post-operative hospital stays, and helps patients regain their bladder and sexual functions quicker.

The Lancet authors said long-term studies are necessary to understand if robotic-assisted surgery can improve patient outcomes over a number of years.