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Training

There are certain skills involved in “driving” the robot. Fortunately, they are quickly acquired. From a surgeons standpoint, these skills include:

  • Knowing where to put the ports for the instruments so as to minimise any clashes.
  • Once the ports are inserted, parking the robot close to the patient and attaching the arms of the robot to the ports that have just been inserted. This is called docking.
  • Choosing which instruments to use in each arm depending on the task at hand.
  • Becoming familiar with the foot pedals which control the camera, diathermy, switching the instruments, resetting the positions of the joysticks.
  • Becoming familiar with the movements of the joysticks in order to control the instruments inside the abdomen.
  • Knowing how to work cooperatively with the bedside assistant in helping to retract some organs and not clashing with the robotic instruments.
  • Knowing how to hold a fine needle with small instruments in order to stitch tissues together.
  • Knowing how to tie knots with fine instruments.
  • Being able to do the same operation with the open technique.

These are only some of the important skill required. It is generally agreed that learning to use the robot is far easier than learning conventional laparoscopy! If this holds true then many more surgeons and gynaecologists will be able to offer keyhole surgery in the future once the costs come down and the robot is more easily available.

In the UK there are very few gynaecologists who are accredited by Intuitive Surgical to carry out robotic surgery in gynaecology. They keep a database of these surgeons on their website. I was one of the first few gynaecologists accredited and have been so since April 2011.

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Requirements