Robotic Surgery in Thoracic Surgery Training Programs: Results of a National Survey

S. Kim¹, N. S. Lui², B. Mitzman³, M. Rochefort⁴, D. D'Souza⁵, M. Sancheti⁶, S. Yang^7
1Northwestern Memorial Hospital, Chicago, Illinois ²Stanford University, Stanford, California ³University of Utah, Salt Lake City, Utah ⁴Brigham and Women's Hospital, Brookline, Massachusetts ⁵The Ohio State University Wexner Medical Center, Columbus, Ohio ⁶Emory, Atlanta, Georgia ⁷Johns Hopkins University Medical Center, Baltimore, Maryland

Purpose: Robotic-assisted thoracoscopic surgery is becoming a significant component of surgical practice among thoracic surgeons. However, cardiothoracic surgical trainees perceive a need for more instruction and exposure to robotic surgery during their training. We sought to assess resident exposure to robotic surgery to identify areas to improve and standardize training.

Methods: A voluntary electronic survey of 10 questions was distributed to surgeons working in all thoracic surgery residency programs in the United States. The survey asked to provide the size of the residency, the availability and utilization of robotic surgery in the training program, and the adoption of robotic surgery by trainees in their independent practice. The data were compared between training programs with different sizes and robotic surgical volumes. ANOVA was used to determine p-values for continuous variables and Fisher exact t-test for categorical variables.

Results: Of the 76 cardiothoracic surgery training programs, 69 (90.8%) training programs had a surgeon complete the survey. All CT surgery training programs, except one, routinely perform and have dedicated OR time for robotic surgery. The majority of pulmonary lobectomies were performed using robotic surgery (55%). About half of the training programs (35/69) have a formal robotic curriculum for the residents. Of 121 thoracic-track residents who completed training from 2020-2022, 118 residents (97.5%) perform robotic surgery as part of their practice, while 61 of 149 (56.5%) cardiothoracic (CT) track and 16 of 149 (10.7%) cardiac-track residents perform robotic surgery. Of 69 respondents, 39 (56.5%) thought robotic elements should be a part of the ACGME requirement, and 57 (82.6%) surgeons wanted robotic proficiency in hiring a new partner. The residents from larger training programs had a higher chance of adopting robotic surgery in their practice (p < 0.01), while relative robotic surgery volume showed no difference (p=0.66).

Conclusion: Most cardiothoracic and thoracic residents regularly perform robotic surgery in their practice after graduation, and robotic proficiency is highly desirable in hiring a new partner. Only half the training programs in the United States have a dedicated curriculum, and disparity in robotic training may exist among residencies of different sizes. A standardized curriculum and training assessment may be needed to ensure optimal preparation for future graduates.

Identify the source of the funding for this research project: Internal Institutional Funding