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Title:Safe implementation of robotic colorectal surgery : balancing surgical training and patient safety with the dual-console system
Authors:ID Košir, Jurij Aleš (Author)
ID Petrič, Miha (Author)
ID Trotovšek, Blaž (Author)
ID Norčič, Gregor (Author)
ID Grosek, Jan (Author)
Files:.pdf PDF - Presentation file, download (408,58 KB)
MD5: 51CA5B1457279490DFA65FB2793E0FF5
 
URL URL - Source URL, visit https://www.mdpi.com/2077-0383/15/14/5669
 
Language:English
Typology:1.01 - Original Scientific Article
Organization:Logo UKC LJ - Ljubljana University Medical Centre
Abstract:Background: Robotic platforms expand minimally invasive options in colorectal surgery but raise concerns about training and patient safety. Dual-console systems may enable realtime coaching while preserving outcomes. Methods: We implemented a structured framework for safe implementation of robotic colorectal surgery that balances trainee autonomy with patient safety using a dual-console model. Early cases emphasized low-complexity pathology with escalation by predefined benchmarks. We prospectively gathered data and evaluated early program outcomes with primary endpoints including intraoperative adverse events, conversion to open surgery, 30-day morbidity, anastomotic integrity, and oncologic quality metrics. Secondary endpoints included operative time. Results: We included the analysis of 17 patients operated by one surgeon under supervision and compared the results to other senior colorectal surgeons. Out of the 17 patients, there were no conversions or anastomotic leaks. Overall complications were comparable to baseline robotic cases. Resection margins and lymph node yields met oncologic standards. Operative times were longer during early adoption but approached baseline with progression. Operative times were significantly reduced after eight cases and approached the times of senior surgeons after 13 cases. Conclusions: A dual-console strategy enables safe, scalable training in robotic colorectal surgery without compromising short-term patient outcomes or oncologic quality. Key elements include rigorous case selection, proficiency-based progression, real-time coaching, standardized protocols, and continuous data surveillance. This framework can guide institutions seeking to expand robotic colorectal programs while safeguarding patients and accelerating the learning curve.
Keywords:robotic colorectal surgery, learning curve, safe implementation, complications
Publication status:Published
Publication version:Version of Record
Year of publishing:2026
Number of pages:str. 1-7
Numbering:Vol. 15, iss. 14, [article no.] 5669
PID:20.500.12556/DiRROS-31184 New window
UDC:617
ISSN on article:2077-0383
DOI:10.3390/jcm15145669 New window
COBISS.SI-ID:285399299 New window
Note:Nasl. z nasl. zaslona; Opis vira z dne 20. 7. 2026;
Publication date in DiRROS:20.07.2026
Views:125
Downloads:75
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Record is a part of a journal

Title:Journal of clinical medicine
Shortened title:J. clin. med.
Publisher:MDPI
ISSN:2077-0383
COBISS.SI-ID:5405759 New window

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License:CC BY 4.0, Creative Commons Attribution 4.0 International
Link:http://creativecommons.org/licenses/by/4.0/
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

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