Role and Training of the Bedside Surgeon in Robotic Surgery: A Survey Among French Urologists-in-Training

Abstract

Francois Lagrange,1 Gaelle Fiard,2,3 Clement Larose,1 Pascal Eschwege,1 Jacques Hubert1,4 1Department of Urology, University Hospital Nancy-Brabois, Vandœuvre-lès-Nancy, Nancy, 54511, France; 2Department of Urology, Grenoble Alpes University Hospital, Grenoble, 38043, France; 3University Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, 38043, France; 4IADI-UL-INSERM (U1254), University Hospital Nancy-Brabois, Vandœuvre-lès-Nancy, Nancy, 54511, FranceCorrespondence: Francois Lagrange, Tel +33 83 15 31 52, Email f.lagrange@chru-nancy.frIntroduction: Due to the development of robotic surgery, surgeons operating at the console are physically separated from the patient. They must rely on help from an assistant, also called bedside surgeon. This study aimed to investigate the habits and practices of French urologic residents when performing this role and to determine whether they expected specific training to qualify as bedside surgeons.Materials and Methods: A web-based survey was sent to French urology residents and fellows using the mailing-list of the French Association of Urologists in Training (AFUF).Results: Over a 3-month period, 86 residents and fellows responded to the survey. Seventy-five (87.2%) thought that an experience as bedside surgeon was useful to acquire console surgeon status and, more specifically, 48.2% of them indicated that this former experience was vital. Nearly 64% considered that learning robotic surgery was essential during residency and fellowship. Overall, 91.9% believed that bedside surgeons should receive a formal training. They were 69.7% to need 5 to 10 procedures to feel confident as bedside surgeon. Almost 75% underwent laparoscopic training on simulators. Having access to a surgery school significantly increased the probability of receiving laparoscopic training on simulators (p = 0.0033).Conclusion: French urology residents and fellows expect a specific training program for bedside surgeons to increase their level of confidence and to get familiar with the device during their first robotic procedures. For them, a bedside surgeon program on a regional/national level would be required.Keywords: education, residency, surgical training, robotic training, robot