Help or Hoopla?: Surgical robots can benefit otolaryngology

Intuitive Surgical, Inc. coordinates a certification program that includes basic robotic techniques, an eight-hour lab involving pigs and a half day of surgeon-led cadaver training and case observation, followed by proctoring during the first few independent cases.

The SRS also recently began offering a transoral robotic surgery fellowship certification for fellows who graduate from SRS-certified programs. Fellowship certification programs include a didactics program approved by the SRS (typically about 20 hours worth of work) and plenty of console time (up to 90 hours); porcine and cadaver training are encouraged but not required.

“We know from the data submitted to the FDA that the learning curve is about 20 cases, so we require that the fellow sits at the console for 20 cases and that they assist on ten other cases,” Dr. Weinstein said. “In that way, we know that the graduating fellows meet certain standards before they start doing robotic surgery.”

Post-graduate robotic training involves approximately 25 hours worth of online, console and laboratory training, Dr. Weinstein said.

Whatever your path to certification, practice is the key to proficiency. “Doing one case every two or three months is not going to get you through the learning curve,” Dr. Kuppersmith said. “You have to have a sufficient volume of these cases to warrant going through the learning curve and to make it worth your while.”

Robotic surgeons say TORS and robotic thyroidectomy are just the beginning. “We’re now in robotics where we were with sinus surgery in the 1980s,” Dr. Eibling said. “We’re still developing the instrumentation, the indications, the procedures and the strategies that are required to move us forward.”