Learning and Teaching Surgery

Abstract

Journal of Gynecologic SurgeryVol. 39, No. 5 EditorialFree AccessLearning and Teaching SurgeryMitchel S. HoffmanMitchel S. Hoffman—Mitchel S. Hoffman, MD, Editor-in-Chief Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA.MCC GYN Program, Moffitt Cancer Center, Tampa, Florida, USA.Search for more papers by this authorPublished Online:3 Oct 2023https://doi.org/10.1089/gyn.2023.0087AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail A surgeon must select from among 3 routes for performing a hysterectomy: vaginal; open abdominal; or laparoscopic. In addition, there are variations of these approaches that include robotic and vNOTES [vaginal natural orifice transluminal endoscopic surgery].The first article of this issue has Drs. Kristin N. Taylor and Kenneth H. Kim (MD, MHPE) from the Samuel Oschin Cancer Center at Cedars–Sinai Medical Center (Los Angeles, CA) providing a historical perspective on the use of robotics in gynecologic surgery. Dr. Kim, an internationally renowned expert on the subject, adds thoughts on future directions that this evolving technology might take.As an introduction to this article, I would like to comment on surgical training in robotic surgery. During an open abdominal operation, the attending surgeon can readily demonstrate, observe, control, and correct surgical steps with a trainee. The same is true, although to a lesser extent, for vaginal and laparoscopic surgery. Robotic surgery is unique in this respect. The individual operating at the surgeon console has complete control, at least momentarily, of the operation. The attending surgeon can point, draw a line, control an assisting robotic instrument (dual console), and resume complete control very rapidly.The complete transfer of control of robotic surgery to a trainee highlights 2 important issues. First: Even with only momentary control, a catastrophic complication may occur (such as moving scissors that are out of the field of view and puncturing a major vessel). Second: How do we effectively teach complex gynecologic surgery without being able to continuously demonstrate or redirect the trainee should the need to do so arise during the case? There are no clear answers to these questions, although the development of the teaching console and the ability of the educator to control 1 of 3 instruments have been major advances with respect to teaching robotic surgery. Currently, the major focus of the Taylor and Kim article provides the best answer to balancing surgical safety and education in robotic surgery with the use of a priori simulation-based training.This article presents a very relevant point of view regarding how sophisticated data developed from the robotic simulator will push education beyond practice and basic feedback to practice, leading to very sophisticated feedback, and eventually to achieving proficiency in robotic surgical techniques.As a profession it is important that we approach advances in surgical technology responsibly, especially with regard to training.I invite readers of this journal to communicate their thoughts to me regarding surgical education and the incorporation of new technology for surgical care by submitting Letters to the Editor.FiguresReferencesRelatedDetails Volume 39Issue 5Oct 2023 InformationCopyright 2023, Mary Ann Liebert, Inc., publishersTo cite this article:Mitchel S. Hoffman.Learning and Teaching Surgery.Journal of Gynecologic Surgery.Oct 2023.203-203.http://doi.org/10.1089/gyn.2023.0087Published in Volume: 39 Issue 5: October 3, 2023PDF download