Skip to main content

Robotic/Minimally Invasive Curriculum

GOALS AND OBJECTIVES:

  • List the essential components of the da Vinci©  robotic surgical system (dVRSS)
  • Describe the systems capabilities of the dVRSS and each of its components
  • Describe the technical functionality of the dVRSS, including troubleshooting strategies
  • Describe proper port placement for specific surgical procedures
  • Demonstrate proper port placement, patient-cart docking and instrument insertion & exchange
  • Demonstrate proficiency in use of masters, camera & clutch
  • Demonstrate proficiency in basic robotic and laparoscopic technical skills
  • Demonstrate proficiency in basic robotic and laparoscopic skills in an animate training environment
  • Demonstrate proficiency as a surgical bedside assistant during robotic and laparoscopic surgery
  • Demonstrate proficiency in understanding surgical steps and anatomy
  • Demonstrate proficiency in basic and advanced robotic and laparoscopic skills under faculty supervision

PG Year 1 & 2 

  • Robotic and Laparoscopic Course in the AUA Core Curriculum
  • Complete the Basic Fundamentals of Robotic Surgery module and pass the MCQ exam associated with this module.  
  • Complete Basic Robotic Procedure modules associated with Radical Prostatectomy, Partial Nephrectomy, Pyeloplasty, Sacrocolpopexy and pass the specific module associated MCQ exam.
  • Box training and robotic simulator is recommended but optional

PG Year 3

  • 2 hours basic robotic skills training with the simulator to 80% proficiency level scores on all modules
  • 2 hours basic clinic robot setup, docking, instrument management and troubleshooting with clinical robot
  • 2 hours of basic robotic skills training with the clinical robot
  • 1 hour of training on laparoscopic box trainer

PG Year 4  

  • Continue practice of simulated tasks
  • Review modules and videos to learn steps for:
    • Robotic Prostatectomy
    • Robotic Partial Nephrectomy
    • Robotic Cystectomy
    • Robotic Pyeloplasty
    • Robotic Sacrocolpopexy
    • Laparoscopic Nephrectomy
  • Position patient, plan and perform port placement, appropriately dock robot
  • Proficiently perform all bedside assistant tasks
  • Perform select steps of cases under direct faculty supervision
    • Robotic Prostatectomy
      • Interperitonealizing bladder (dropping bladder)
      • Opening of endopelvic fascia
      • Dissection of seminal vesicles and vas ampulla
      • Forehand suturing during UV anastomis
    • Robotic Partial Nephrectomy
      • Medial mobilization of colon
      • Kocherization of duodenum
      • Identification and dissection of gonadal vein
      • Elevation of kidney, posterior dissection, and hilar identification
      • Opening of gerotas fascia and tumor identification         
    • Robotic Cystectomy
      • Mobilization of ureters
      • Dissection of perivesical space
      • Interperitonealizing bladder (dropping bladder)
      • Opening of endopelvic fascia
      • Urethral dissection for patients undergoing ileal conduit
    • Robotic Pyeloplasty
      • Medial mobilization of colon
      • Identification and dissection of ureter
      • Identification of stricture or affected segment
    • Robotic Sacrocolpopexy
      • Identification and mobilization of sigmoid colon
      • Identification of sacral promontory and dissection of overlying tissue
      • Fashioning graft material and suture placement
    • Laparoscopic Nephrectomy
      • Be able to do all steps of the procedure

PG Year 5  

  • Transfer knowledge of simulated tasks to operating room
  • Review modules and videos to learn steps for:
    • Robotic Prostatectomy
    • Robotic Partial Nephrectomy
    • Robotic Cystectomy
    • Robotic Pyeloplasty
    • Robotic Sacrocolpopexy
    • Laparoscopic Nephrectomy
  • Position patient, plan and perform port placement, appropriately dock robot
  • Perform all steps of cases under direct faculty supervision
  • When available, we will practice basic and advance skill test on live animal models.

Basic Robotic Skill Tasks   

PART  1   

RING TRANSFER (orientation & dexterity)

  • use rubber stopper peg model
  • start with rings on pegs
  • use your R hand to pick up each rubber band, transfer it to your L hand, then place it on the Velcro base
  • once all rubber bands are removed, place them back in reverse order, starting with your R hand to pick up the rubber bands and then transferring it to your L hand before placing back on the pegs
  • you will repeat this task a total of 3 times (total of 18 transfers)

ROBOTIC SIMULATOR

  • Endowrist manipulation Peg Board 1 At least x3 times to go through the exercise

RING TRANSFER BETWEEN MODELS  (orientation, dexterity, camera and clutch movement)

  • use 2 rubber stopper peg models
  • start with rings on model on R side
  • use your R hand to pick up each rubber band, transfer it to your L hand, then place it on the pegs on the model on the L side
  • once all rubber bands have been transferred, place them back in reverse order, starting with your L hand and then transferring it to your R hand and placing it on the pegs on the R side model
  • you will repeat this task a total of 3 times (total of 18 transfers)  

ROBOTIC SIMULATOR

  • Endowrist manipulation Peg Board 2 At least x3 times to go through the exercise

THREADING THE LOOPS

  • use S hook pod and 12cm 2-0 prolene suture (no needle)
  • using 12cm 2-0 prolene, pass the suture through the loops from #1 position to #10 position (in order) using your R hand to initially pass the suture through the loops 
  • repeat this again using your L hand to initially pass the suture through the loops
  • you will repeat this task a total of 3 times per hand (total of 6 threadings)

ROBOTIC SIMULATOR 

  • Camera and clutching
  • Ring walk 1 At least x2 times to go through the exercise
  • Ring walk 2 At least x2 times to go through the exercise
  • Ring walk 3 At least x2 times to go through the exercise  

NEEDLE PASSING

  • use S hook pod and Rb1 needle with 2cm suture tail
  • pass needle through loops starting at #1 position to #10 position (in order) using your R hand
  • repeat this again using your L hand
  • avoid excessive strain on the model by following curve of needle
  • you will repeat this task a total of 3 times per hand (total of 6 threadings)

ROBOTIC SIMULATOR

  • Needle control
  • Thread the rings 1 At least x3 times to go through the exercise
  • Thread the rings 2 At least x3 times to go through the exercise
  • Needle targeting  At least x1 times to go through the exercise   

PART 2

NEEDLE DRIVING  

  • use Dots & Numbers model and an SH needle
  • pick up the needle and pass it through the 6 different marked points around the circle in the order indicated using your R hand to pass the needle       
  • repeat this again using your L hand
  • you will repeat this task a total of 3 times per hand (total of 18 passes of needle per hand)

ROBOTIC SIMULATOR

  • Needle Driving
  • Dots and Needles 1
  • Dots and Needles 2    

INTERRUPTED SUTURING 

  • use suture slab and a 3-0 vicryl/silk on SH needle (10cm)
  • pick up the suture with your R hand and place an interrupted suture through the marked dots (single bite)
  • now tie 5 knots with the first knot being a surgeon's knot
  • repeat this again using your L hand
  • you will repeat this 3 times per hand (total of 3 sutures & 15 knots per hand)

CONTINUOUS SUTURING

  • use suture slab and a 3-0 vicryl/silk on SH needle (20cm)
  • pick up the suture with your R hand & place an initial anchoring suture through the marked dots (single bite)
  • then tie 5 knots with the first knot being a surgeon's knot
  • place 10 running continuous sutures with your R hand through the marked points (take in 2 bites)
  • repeat this again with your L hand
  • you will repeat this 3 times per hand  (total of 30 sutures & 15 knots per hand)  

TISSUE ANASTOMOSIS

  • use 4-in-1 model and two 2-0 monocryl sutures tied together with RB1 needle (8inch each arm)
  • complete a UV anastomosis
  • repeat this 3 times
Last modified: Sep 28, 2018
ID=x30268