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 IRB-approved, 15-question survey was distributed electronically. 98 responses were received for a rate of 44%. Linear regression and ANOVA statistical analysis were performed.
Setting: Eight Ob/Gyn residency programs in the US
Patients or Participants: Current Ob/Gyn resident physicians
Interventions: Survey distribution
Measurements and Main Results:
The majority of respondents were satisfied with their robotic surgery experience (RSE). All respondents reported experience with uterine manipulation or bedside assisting by PGY2. Earliest experience performing hysterectomy was most common in PGY2 or PGY3.
76% of PGY3 or PGY4 residents report operating on the console for some or all of the surgery with 69% having participated in greater than 20 robotic surgery cases. Respondents report RSE with attending gynecologic oncologists (97%), MIGS (87%), Urogynecologists (56%) and generalists (38%), though only exposure to MIGS faculty is significantly associated with a high number of RSE (p=0.0221).
Overall satisfaction with RSE increased significantly with higher level of participation (p<0.0001), particularly operating at the console some or most of the surgery; longitudinal experiences with hysterectomy, myomectomy and salpingectomy/oophorectomy (p<0.05); but not with bedside assisting or vaginal cuff closure. Factors most limiting sitting at the robotic console included time constraints, lack of first assists, case complexity, and attending comfort.
Conclusion:
Ob/Gyn resident satisfaction with training is significantly related to level and duration of hands-on participation. MIGS 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 achieving resident autonomy in robotic surgery.
Snyder, AE*1, Farmer, L2, Caraher, E3, Cheeks, M4, Correa, J5, Parra, NS6, Wainger, JJ7, Yakubu, A8, Buery-Joyner, S1. 1Obstetrics and Gynecology, Inova Fairfax Medical Campus, Falls Church, VA; 2Obstetrics and Gynecology, Duke University Hospital, Durham, NC; 3Obstetrics and Gynecology, New York- Presbyterian Hospital Brooklyn Methodist, Brooklyn, NY; 4Obstetrics and Gynecology, Northwestern University, Chicago, IL; 5Obstetrics and Gynecology, University of California San Francisco, San Francisco, CA; 6OBGYN, Columbia Irving Medical Center - New York Presbyterian Hospital, New York, NY; 7Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD; 8Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA