Impact of Robotic Single and Dual Console Systems in the Training of Minimally Invasive Gynecology Surgery (MIGS) Fellows

Abstract

Study Objective To evaluate fellow console time, surgical steps performed, and surgical takeovers between attending and fellow using a dual versus (vs) single console robotic systems. Design Quality improvement project evaluating use of dual consoles in robotic surgical education. Setting MIGS fellowship program in an academic institution's tertiary care center. Patients or Participants Two MIGS fellows and 5 subspecialty trained gynecologic surgeons. Interventions Variables were prospectively collected for 62 robotic surgeries and included: dual vs single console, trainee console time, trainee, attending, surgical takeovers, docking time, type of surgery, steps performed by trainee, complications, total case time, specimen weight and estimated blood loss. Demographic patient data were also collected. Variables were compared using the Wilcoxon Rank Sum test (continuous), and the Pearson Chi-square test (categorical). Measurements and Main Results Fellows spent more time at the console in dual console operations compared to single (56 vs. 36 min, P=0.002). There were 11 (31%) single console procedures where the fellow had no control compared to dual console where the fellow assumed control every time (P=0.001). Median number of surgical takeovers was higher in dual console operations (3 vs. 1, P Conclusion Dual console robotic training provide fellows the opportunity for more hands on experience and more interaction between the fellow and surgical attending, with an increased number of surgical takeovers. This opportunity presents itself at the cost of a longer case time but with similar complication rates. ned IUDs. Knowledge of the alignment of the IUD to the longitudinal axis of the uterus and the degree of embedment, or perforation, allows for employing the most appropriate technique. Although removal can often be achieved in the office, deeply embedded IUDs or IUD fragments may require the operating room setting for safe extraction.