Surgical Robo-Talks

For robotics surgeons with long careers and a desire to pass on their skills, it can be tricky to get back into the mindset of a trainee. And this can make it hard to design effective training experiences that put trainees and their needs first. But for our guest today, the journey from trainee to consultant to trainer all happened within the last 6 years, giving her a unique insight into how to meet their educational needs.

In this episode of Surgical Robo-Talks, Jessica and co-host, Fahad Ullah (Colorectal Trainee and ASiT Past Robotic Lead) are joined by Consultant Colorectal Surgeon at Manchester University NHS Foundation Trust, Deena Harji.

They’ll discuss Deena’s journey to find out how she went from trainee to trainer and learn how her experience has shaped the way she teaches her own trainees. We’ll also hear what advice Deena has for trainees wanting to make robotics part of their career and we’ll find out what skills they can learn to help their robotic tuition along before getting hands-on experience with a robotic unit.

Plus, we’ll hear why mentors are so important and discover how trainees can find their own.

We’ll also ask:

• (3:09) - What was Deena’s journey from trainee to trainer like?
• (4:52) – Did Deena know that the future of her speciality was in robotics?
• (7:28) – What advice does Deena have for trainees wanting to get experience on surgical robotic platforms?
• (10:09) – Does Deena think that observing robotic-assisted surgery enhances or detracts from trainee surgical experiences?
• (13:16) – In Deena’s experience, can there be a transference of skills from one robotics system to another? And what are the key aspects of robotic-assisted surgery that a trainee must understand?
• (16:42) – How has Deena seen robotics training evolve and what more does she think needs to be done to improve training?
• (19:52) – What kind of exposure to robotics would Deena recommend to trainees at each level of their journey?
• (22:40) – What was Deena’s experience transitioning from trainee to consultant to robotics trainer?
• (25:55) – Are there any low-cost solutions that can help trainees to acquire additional skills to prepare them for training on robotic systems?
• (28:29) – How important are mentors in robotic-assisted surgery? And how did Deena find hers?
• (30:50) – Where does Deena think robotics will be in the next five years?

Robotic-assisted surgery can often feel like a technology straight from the world of sci-fi. Units with multiple articulating arms, sometimes operated by surgeons in separate rooms, can make these systems feel completely alien to traditional open surgery methods. And this image can present a hurdle to patients (and even some surgeons) for fear that the technology is too new and not tried and tested enough.

But as any seasoned robotic surgeon will tell you, robotics is just the next evolutionary step in surgery. From open surgery, to laparoscopic, to robotics, the ways in which operations are carried out are always changing, adopting new technologies and ever-better techniques.

In our season finale of Surgical Robo-Talks, we’ll be finding out how this surgical discipline has developed and how it’s making its mark on the surgical world with help from consultant colorectal surgeon and president-elect of the Association of Coloproctology of Great Britain and Ireland, Jared Torkington. Our co-host today is consultant colorectal surgeon at University Hospital Limerick and past vice president of the Association of Surgeons in Training, Christina Fleming.

They’ll discuss how advances in laparoscopic surgery paved the way for robotic-assisted surgery and explore how the two were both received by the medical community when they first emerged. Plus, we’ll learn how robotic-assisted surgery could be incorporated into colorectal surgical training and ask what advances we might see in robotics in the coming years.

We’ll also ask:

• (3:24) - How did laparoscopic surgery go from experimental practice to mainstream method?
• (5:56) – What caused the change in approach to laparoscopic surgery in the 1990s?
• (8:29) – Where does Jared feel the benefits lie in robotic-assisted colorectal surgery?
• (11:18) – How do you explain to patients that robotic-assisted surgery is just a progression from laparoscopic surgery and open surgery?
• (13:43) - Where was Jared when robotic-assisted surgery first appeared in soft-tissue surgery? And what was the general feeling towards it?
• (16:03) - Are more randomized trials needed to verify the success rates and benefits of robotics?
• (18:51) - Should registries be a standard part of robotic-assisted surgery?
• (20:52) – What do surgeons think about participating in registries?
• (24:09) – How should robotics be incorporated into robotic-assisted surgical training?
• (26:26) – Should surgical trainees be trained given the plethora of robotics platforms available?
• (29:36) - How could robotic-assisted surgical training be introduced in parallel to the current training systems?
• (35:06) - How could robotic-assisted surgery and its adoption evolve over the next five years?

As interest in robotic assisted surgery continues to rise among both qualified and trainee surgeons, the competition for getting those all-important hours on robotic systems is getting tougher. But with robotics not forming part of the core surgical curriculum across disciplines, getting all those interested access to units is no easy task.

But what if robotics was part of the surgical curriculum?

How and when would it be introduced to trainees? Would it be enough to give trainees the access they need to qualify? And how would institutions deliver this curriculum?

In this episode of Surgical Robo-Talks, Jessica is joined by co-host, Josh Burke (Academic Colorectal Registrar, Past President of ASiT and Director of Education for The RCS England Innovation Hub) to discuss the introduction of a robotics curriculum to the world of gynaecological surgical training. They’ll be joined by consultant laparoscopic and robotic pelvic surgeon, Nahid Gul, to discover how robotics training is being integrated into the wider gynaecological surgical curriculum and how it could be rolled into other surgical disciplines.

We’ll find out how robotic-assisted surgery impacted Nahid’s own laparoscopic practice and how it could benefit others. Plus, we’ll discover when Nahid thinks robotics should be introduced to trainees and how trainers should approach the issue of cross-platform training.

We’ll also ask:

• (2:54) - What impact will robotic-assisted surgery have on surgical practice in the future?
• (4:28) - How did Nahid transition from open surgery to robotic-assisted surgery?
• (6:39) - When should training in robotic-assisted surgery start?
• (9:46) - How should trainees prepare themselves before undertaking robotics training?
• (11:49) - When (and how) should trainees be taught about different robotic systems?
• (14:26) - Can there be a transfer of qualifications from one robotic system to another?
• (16:31) - How did Nahid tackle the challenge of standardisation when it came to implementing a curriculum?
• (18:14) - How can curriculums account for different robotic systems?
• (20:03) - Are there any technical aspects of the gynaecology robotics curriculum that are agnostic of the robotic system? For example, emergency undocking.
• (20:58) - How do you approach training the trainers?
• (22:11) - What challenges did Nahid encounter when implementing a curriculum?
• (25:05) - Does Nahid think a modular approach to training and qualification is safe and sustainable?
• (26:47) - Is surgical training delivered via video and virtual reality valuable?
• (28.23) - Are there any additional tools that can help trainees embark on their robotics training?
• (29:31) - What advice does Nahid have for surgeons on their robotics training?

The UK Robotic-assisted surgery landscape has come a long way since it was first introduced in 2001. As technologies like high-resolution monitors, virtual reality, kinematic data technology and more continue to augment robotics, this surgical discipline is increasingly becoming more advanced at a tremendous rate.

But with access to robotic units among trainees so scarce, it can be difficult to keep up with the latest evolutions to truly understand how revolutionary the technology is becoming.

In our first episode of Surgical Robo-Talks, host, Jessica Butterworth (Society, KOL and Procedural Training Manager at CMR Surgical) and special guest co-host, Martin King (General Surgery Registrar based in Northern Ireland, and Immediate Past-President of the Association of Surgeons in Training UK & Ireland), speak with Chief Medical Officer of CMR Surgical, Mark Slack.

We’ll hear how Mark’s experience led him to a career developing the next generation of robotic-assisted surgery systems and how systems and training could be implemented into the surgical curriculum to improve the skills of both qualified surgeons and surgeons in training. Plus, Mark gives us his vision for the future of robotic-assisted surgery and details the safety measures we need to consider as AI begins to integrate into systems.

We’ll also ask:

• (3:17) - What led Mark to his position as CMO at CMR Surgical?
• (6:11) - How is robotic-assisted surgery benefitting patients?
• (8:33) - What does the typical learning curve for surgical trainees getting to grips with robotics look like?
• (11:11) - Will we see standardisation of techniques across different robotic platforms in the future?
• (13:33) - Could skills be translated from one system to another?
• (15:38) - How might big data and AI impact robotic-assisted surgery?
• (17:46) - How far away are regulator bodies from assessing the role of AI in robotic-assisted surgery?
• (20:21) - How will the increase in regulation and credentialing of new technologies impact surgeons’ careers?
• (22:44) - How quickly should we integrate new technologies into the surgical curriculum?
• (25:03) - How are robotic units helping with data capture?
• (28:56) - How can surgical trainees set themselves up for a successful robotics education before getting exposure to the systems?
• (31:14) - How does Mark see robotics evolving in the years to come?

Find out how the world of surgical robotics training is evolving with Surgical Robo-Talks. Each episode, our host, Jessica Butterworth (Society, KOL and Procedural Training Manager at CMR Surgical), and co-hosts from the Association of Surgeons in Training sit with practising robotics surgeons to learn about the tools and technologies improving surgical practice, how standardised curriculums are simplifying the qualification journey and much more.

Coming October 2023.