Low confidence levels with the robotic platform among senior surgical residents: simulation training is needed.

Acquisition of robotic surgical skills by surgical residents is usually hindered by time pressure and financial imperatives. Robotic simulation training offers an attractive solution because it allows residents to learn in a safe, controlled, and standardized environment. We aimed to determine the confidence levels of senior surgical residents with the robotic platform, and how those levels were affected by simulation training. Twenty senior residents participated in a simulation course using perfused porcine tissue blocks to perform the following robotic procedures: Nissen fundoplication, Heller myotomy, sleeve gastrectomy, colectomy, and lobectomy. Procedural steps evaluated included port placements, docking process, suturing, using energy devices, and using staplers. Mean baseline confidence levels were low for all the surgical steps analyzed, and all these values significantly increased after the 3-day robotic training in the simulation center. A standardized formal robotic simulation program with realistic hands-on training should be incorporated in the general surgery residency curriculum.