Physicians at Loyola Medicine have developed an online system to improve the logging of robotic surgeries performed by surgeons in training to better document their specific involvement in these surgical procedures.
The web-based system, called RoboLog, provides detailed information about a resident’s involvement in robotic surgeries. The system was successfully piloted documenting more than 300 urologic robotic surgeries—the total now stands at more than 600—and including 11 common urologic robotic procedures. Results of the pilot were recently published in the Journal of Surgical Education.
According to Gopal Gupta, MD, an expert in urologic oncology and robotic surgery at Loyola, robotic-assisted surgery has been pioneered by urologists and is the most common technique performed for prostate cancer surgery. Nonetheless, he contends that there is no standardized training in robotic surgery for residents and fellows and few guidelines for determining competency.
“We did not have a system to adequately assess who is qualified to be giving robotic surgery, and what is their competence using this approach,” says Gupta. “It really came from a perspective of training future surgeons in our residency program.”
Gupta and his colleagues developed RoboLog to help fill this gap and come up with a system that accurately reflects a trainee’s actual robotic experience.
While the Accreditation Council for Graduate Medical Education has a logging system for robotic cases, Gupta points out that a resident who performs only one part of a robotic prostate cancer surgery—such as removing the lymph nodes—gets the same credit using the ACGME system as a resident who performs the entire surgery.
“With that system, a resident can log their surgery case experience as either a surgeon or an assistant,” he laments. “So, they could do 10 percent of a case with the attending surgeon and log it as surgeon.”
However, the new system provides a “robotic surgery case log that’s very granular,” Gupta notes. As a result, he says it can be used to track robotic training progress or to identify any deficits that need to be addressed.
For instance, Gupta observes that residents using RoboLog check each step they took in surgery and how many minutes it took them to perform. And, with the new system, he adds that a trainee can get subjective feedback on the strengths and weaknesses of their robotic surgery skills and it can also be used in the development of a standardized curriculum.
“Every three months, the attending surgeon and the trainee get a report that’s generated indicating how many procedures, what types of procedures were performed, as well as the participation in each step of the procedures, the time it took to complete, and a summary of subjective feedback,” says Gupta.
According to Gupta, Loyola Medicine plans to make RoboLog available to other health systems. He concludes that they have “started to collaborate with some of the training programs at Boston and New York area hospitals to get a multi-institutional perspective.”
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