Initial Experience Training Otorhinolaryngology Residents in Transoral Robotic Surgery

Abstract

Objective: 1) Describe a safe, efficient, and effective pathway for the development of transoral robotic surgical skills in otorhinolaryngology residency training, and 2) Report initial results of resident experience in the training modules.

Method: A curriculum for training otorhinolaryngology residents in transoral robotic surgery (TORS) was defined. The training included PGYII-V residents and progressed through modules, including Didactics, Skills, and Operative. In the skills module, performance measurements in the simulator were recorded. Surveys of PGY-V residents completing the curriculum assessed the program effectiveness.

Results: Didactics teach the device setup, controls, and surgical approaches, via video and texts. Skills-training is primarily completed with a robotic surgery simulator. Introduction to the TORS approach is completed on cadaver models. The operative experience includes live case observation, bedside surgical assistant, and finally console surgeon. The surgical experience advances in a stepwise fashion, with the resident progressing after demonstrating proficiency with preceding steps. Proficiency in the robotic simulator with performance of simple tasks was demonstrated by all participants within a 2-hour initial session. Residents completing the modules expressed satisfaction with their comfort level in performing basic procedures via TORS.

Conclusion: An efficient and effective curriculum for training residents in TORS was developed. This formal training is necessary and effective for residents to acquire the knowledge and skills to perform TORS safely. Further evaluation is warranted to improve the training curriculum and increase training experiences during otorhinolaryngology residency.