A Defined Pathway to Teach and Credential Safe Robotic Thoracic Surgery

Abstract

Robotic surgery is growing in popularity and is an important tool in the armamentarium of the modern cardiothoracic surgeon. The successful development of a robotic general thoracic surgery program begins with appropriate surgeon and team selection. The process of learning how to independently complete operations entirely with a robotic approach depends on a step by step progression of collection of skills and teamwork. The process begins with optimal patient selection, realistic expectations for the first several cases, dedicated robotic time of at least one day a week, and a progression toward competent and safe robotic thoracic surgery. Simpler operations are mastered first; complex operations are broken up into multiple steps of increasing difficulty and risk, which are learned in succession. Adverse events can be avoided and safety maximized by adhering to basic rules of engagement and attending basic and advanced courses that teach teams and not just surgeons. Smooth conduct of the operation can be achieved with practice and using troubleshooting maneuvers when needed and by learning from the mistakes of others.