title: Robotic surgical education: a systematic approach to training urology residents to perform robotic-assisted laparoscopic radical prostatectomy.
abstract: OBJECTIVE
  Robotic-assisted surgery using the da Vinci Surgical System is gaining popularity among urologists. However, training residents to use this system presents new challenges for surgical educators. We describe a method for training residents to perform robotic-assisted radical prostatectomy.
  
  
  METHODS
  Residents first received da Vinci certification training followed by table-side assistance with a second attending urologist present to provide real-time instruction. After demonstrating proficiency with assistance, residents performed segments of robotic prostatectomies as the console surgeon. The procedure was divided into five steps: (a) bladder take-down, (b) endopelvic fascia and dorsal venous complex, (c) bladder neck and posterior dissection, (d) neurovascular bundles, and (e) urethral anastomosis. Performance was rated using an analog scale (0, very poor to 5, outstanding). The resident was allowed to proceed to the next step once proficiency (score greater than 3 of 5) had been demonstrated on three separate occasions. In addition, each procedure was digitally recorded and reviewed with the attending physician after the operation.
  
  
  RESULTS
  Two chief residents underwent this training regimen. All 83 cases with surgical console involvement during a 7-month period were reviewed. The combined residents' mean operative time in minutes and overall performance (score 0 of 5 to 5 of 5) for each step were recorded. Using logistic regression analysis, a statistically significant trend was seen, with faster operative times and greater analog scores over time for both residents (P <0.005).
  
  
  CONCLUSIONS
  A systematic approach can be used to safely and effectively train urology residents to perform robotic radical prostatectomy using the da Vinci robotic system.
authors.affiliation: Center for Prostate Cancer, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Hani H
authors.initials: HH
authors.lastname: Rashid
authors.forename: Yuk-Yuen M
authors.initials: YY
authors.lastname: Leung
authors.forename: Megan J
authors.initials: MJ
authors.lastname: Rashid
authors.forename: Gregory
authors.initials: G
authors.lastname: Oleyourryk
authors.forename: John R
authors.initials: JR
authors.lastname: Valvo
authors.forename: Louis
authors.initials: L
authors.lastname: Eichel
mesh_terms: D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy; D008297:Male; D011468:Prostatectomy / Q000193:education*; D012371:Robotics / Q000193:education*; D013663:Teaching / Q000379:methods; D014572:Urology / Q000193:education*