title: Resident training in a new robotic thoracic surgery program.
abstract: BACKGROUND
  The volume of robot-assisted operations has drastically increased over the past decade. New programs have focused on training surgeons, whereas resident training has lagged behind. The objective of this study was to evaluate our institutional experience with resident participation in thoracic robotic surgery cases since the initiation of our program.
  
  
  METHODS
  The first 100 robotic thoracic surgery cases at our institution were retrospectively reviewed and categorized into three sequential cohorts. Procedure type, patient and operative characteristics, level of resident participation (primary surgeon [PS] or assistant), and postoperative variables were evaluated.
  
  
  RESULTS
  Of the first 100 cases, 38% were lung resections, 23% were esophageal operations, and 20% were sympathectomies. The distribution of cases changed over time with the proportion of pulmonary resections significantly increasing. Patient age (P < 0.05), body mass index (P = not significant [NS]), and comorbidities (P = NS) increased over time. Resident participation as PS increased from 33%-59% between the early and late cohorts (P < 0.05). A subset analysis of the 20 lobectomies (7 attending PS, 13 residents) showed similar patient characteristics (P = NS): age (67 versus 69), body mass index (29.5 versus 26.1), and American Society of Anesthesiologists category (2.8 versus 2.8). Operative and postoperative characteristics were also similar (P = NS) regardless of PS: operative time (260 versus 249 min), estimated blood loss (187 versus 203 mL), and length of stay (4.8 versus 4.7 d).
  
  
  CONCLUSIONS
  Residents can participate as the PS in a variety of thoracic operations during the implementation of a robotics program. Operative time, estimated blood loss, and length of stay were similar regardless of level of resident participation.
authors: Department of Surgery, University of Michigan, Ann Arbor, Michigan.
authors: Yasmine N
authors: YN
authors: White
authors: Department of Surgery, University of Michigan, Ann Arbor, Michigan.
authors: Priya
authors: P
authors: Dedhia
authors: Department of Surgery, University of Michigan, Ann Arbor, Michigan; Section of Thoracic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan.
authors: Edward J
authors: EJ
authors: Bergeron
authors: Department of Surgery, University of Michigan, Ann Arbor, Michigan; Section of Thoracic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan.
authors: Jules
authors: J
authors: Lin
authors: Department of Surgery, University of Michigan, Ann Arbor, Michigan; Section of Thoracic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan.
authors: Andrew A
authors: AA
authors: Chang
authors: Department of Surgery, University of Michigan, Ann Arbor, Michigan; Section of Thoracic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan. Electronic address: reddyrm@med.umich.edu.
authors: Rishindra M
authors: RM
authors: Reddy
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics / Q000193:education* / Q000706:statistics & numerical data; D013903:Thoracic Surgery / Q000193:education* / Q000706:statistics & numerical data
keywords: Graduate medical education; Residency; Robotic skills training; Robotic surgery; Robotic thoracic surgery; Surgical education