Cross Sectional Survey of Ob/Gyn Residents' Graduated Experience With Robotic Surgery.

Abstract

Study objective: Obstetrics and gynecology (Ob/Gyn) resident experience with robotic gynecologic surgery has been evaluated at time of graduation, but no specific surgical procedures were identified to differentiate the experiences of residents at each level. This study proposes to determine which factors are correlated with more hands-on robotic surgery experience and resident satisfaction.

Design: An Investigational Review Board-approved, 15-question survey was distributed electronically. Ninety-eight responses were received for a rate of 44%. Linear regression and Analysis of Variance statistical analysis were performed.

Setting: Current residents at 8 Ob/gyn residency programs in the US were surveyed.

Patients: N/A.

Interventions: Survey administration.

Measurement and main results: The majority of respondents were satisfied (48%) or had neutral feelings (20%) with regard to their robotic surgery experience. All respondents reported experience with uterine manipulation or bedside assistance by postgraduate year (PGY) 2. Earliest experience performing hysterectomy was most common in PGY2 or PGY3. Seventy-six percent of PGY3 or PGY4 residents report operating on the console for some or all major robotic surgeries, with 69% having participated in greater than 20 robotic surgery cases during residency. Only exposure to Minimally Invasive Gynecologic Surgery faculty is significantly associated with high robotic surgery experience (p = .022). Overall satisfaction with robotic surgery experience increased significantly with higher level of participation (p <.0001), particularly operating at the console during some or most of the surgery; longitudinal experiences with hysterectomy, myomectomy, and salpingectomy/oophorectomy (p <.05); but not with sole bedside assisting or vaginal cuff closure. Factors limiting robotic console experience included case time constraints, lack of first assists, case complexity, and attending comfort.

Conclusions: Ob/Gyn resident satisfaction with training is significantly related to level and duration of robotic surgery participation. Minimally Invasive Gynecologic Surgery faculty contribute to more resident experience, and limiting factors include time constraints, case complexity, and lack of first assists. These results can provide a framework for structuring resident training in robotic surgery.