An International Delphi Study to Develop a Consensus on a Robotic Training Curriculum for Gastrointestinal Surgery Trainees: European Robotic Surgery Consensus (Ersc)-European Association for Endoscopic Surgery (Eaes) Initiative
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Fadel M.G.
Walshaw J.
Yiasemidou M.
Boal M.
Pecchini F.
Elhadi M.
Massey L.
Carrano F.M.
Fehervari M.
Nickel F.
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2025
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Introduction: The rapid adoption of robotic surgical systems across Europe has led to a critical gap in training and certification for gastrointestinal (GI) surgical trainees [1]. Following a systematic review of existing multi-specialty robotic surgical curricula [2,3] and a pan-European survey to capture current robotic training practices [4], we generated consensus statements for a Delphi study to develop a robotic training curriculum for GI surgery trainees. Aims & Methods: We aimed to develop a European consensus on a standardised robotic training curriculum for GI surgical trainees. A 99-item statement Delphi questionnaire was finalised by an international Steering Committee and patient and public advocates. The questionnaire was disseminated via Qualtrics XM platform [5] to a multidisciplinary panel of 83 robotic GI surgeons, trainees, representatives from the extended robotic theatre team (including anaesthetists, scrub nurses, robotic practitioners) and industry. A priori consensus standard was set at >=70% for agreement to a statement across two rounds. Result(s): Seventy-one (85.5%) participants, from 15 different countries, completed round one of the Delphi process. Responses were obtained from independent general surgeons (n = 16, 22.5%), upper GI/hepatopancreato-biliary surgeons (n = 15, 21.1%), lower GI surgeons (n = 15, 21.1%), GI trainees (n = 10, 14.1%), robotic theatre team and human factors experts (n = 7, 9.9%), and robotic industry providers (n = 8, 11.3%). Thirty-one (43.7%) participants performed more than 50 robotic cases independently. A total of 77 items (77.8%) reached consensus in the first round, with 32 new statements being generated based on free-text comments. Seventy members (98.6%) completed the 54-item round two questionnaire, with 32 items (59.3%) reaching consensus. Agreement was reached in the following areas on a robotic training curriculum for GI surgery trainees: (i) core learning skills of a bedside assistant and console surgeon; (ii) key components of a robotic training curriculum (including required e-learning modules, wet and dry lab simulation met rics); (iii) performance assessment (including technical skills assessment and clinical metrics); (v) requirements for certification and supervision and (vi) assessment of the long-term impact or success of a GI robotic training curriculum. Conclusion(s): To our knowledge, this study provides the first European consensus and curriculum in robotic training, assessment and certification for GI surgery trainees. This consensus will potentially help shape the future of robotic surgical education, promote standardised training practices and ultimately improve patient safety.
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United.Eur.Gastroenterol.J.