Importance of DaVinci in training?

[wannabeOBGYN]

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How important is it to have access to a DaVinci at the program we match into? One program I went to does not have one (and doesn't appear to be getting one in the foreseeable future). Beyond that, I liked the program, but I'm just not sure how much it matters. I'm not even completely sold on the robot, to be honest. Maybe it's because I've seen it used but haven't gotten to participate so I haven't experienced how awesome it is, but from what I've seen so far, it doesn't seem all that much better than laparoscopy and it adds a lot of time to the surgery. Thoughts/opinions? Thanks!

 

[anonperson]

How important is it to have access to a DaVinci at the program we match into? One program I went to does not have one (and doesn't appear to be getting one in the foreseeable future). Beyond that, I liked the program, but I'm just not sure how much it matters. I'm not even completely sold on the robot, to be honest. Maybe it's because I've seen it used but haven't gotten to participate so I haven't experienced how awesome it is, but from what I've seen so far, it doesn't seem all that much better than laparoscopy and it adds a lot of time to the surgery. Thoughts/opinions? Thanks!

It's hit and miss.

The technology itself is pretty cool. It has definite benefit in gyn onc and urogyn procedures. As far as benign gyn, it does come in handy for patients with severe adhesive disease due to wristed instrumentation and great visualization.

To be honest, the majority of hysterectomies can be done vaginally or with traditional laparoscopy with similar patient outcomes and hospital stays. A lot of programs are having a challenging time integrating residents with the davinci. The davinci company has some fairly annoying requirements including pig lab and proctored cases etc which can make it difficult to have residents be authorized to do davinci cases post residency.

Additionally, attendings at a lot of places are still getting their feet wet with the davinci and if they dont feel comfortable, a resident isnt going to get on the console.

Honestly, go to a program with a lot of vag hysts and regular laparoscopic hysts.

From my experience, surgeons who are good at laparoscopic hysts easily transition to the davinci as the davinci can compensate for worse surgeons in general.

At my program, a fair number of the attendings are doing davinci hysts. I'm comfortable docking the robot and doing basic trouble shooting and first assisting. I've gotten a few chances to sit at the console during cases to sew the cuff etc. It's cool but it's a very specialized tool.

The davinci company has definitely overhyped their product and it is somewhat distressing to see it get so readily accepted.

 

[wannabeOBGYN]

It's hit and miss.

The technology itself is pretty cool. It has definite benefit in gyn onc and urogyn procedures. As far as benign gyn, it does come in handy for patients with severe adhesive disease due to wristed instrumentation and great visualization.

To be honest, the majority of hysterectomies can be done vaginally or with traditional laparoscopy with similar patient outcomes and hospital stays. A lot of programs are having a challenging time integrating residents with the davinci. The davinci company has some fairly annoying requirements including pig lab and proctored cases etc which can make it difficult to have residents be authorized to do davinci cases post residency.

Additionally, attendings at a lot of places are still getting their feet wet with the davinci and if they dont feel comfortable, a resident isnt going to get on the console.

Honestly, go to a program with a lot of vag hysts and regular laparoscopic hysts.

From my experience, surgeons who are good at laparoscopic hysts easily transition to the davinci as the davinci can compensate for worse surgeons in general.

At my program, a fair number of the attendings are doing davinci hysts. I'm comfortable docking the robot and doing basic trouble shooting and first assisting. I've gotten a few chances to sit at the console during cases to sew the cuff etc. It's cool but it's a very specialized tool.

The davinci company has definitely overhyped their product and it is somewhat distressing to see it get so readily accepted.

Thanks for your response, I swear it's like pulling teeth to get anybody to post here. All the other specialties seem so active and then you come to obgyn and you're lucky if there's 1-2 posts a day.

Anyway, back to the topic at hand, I have definitely been keeping an eye out for vag. hyst. #s, but not so much on the lap hysts. Most places seemed to mention they had a lot of laparoscopic cases at the interview so I hadn't been worrying about it, but I will go back and have a look.

A friend of mine who is a obgyn PGY-I said almost everyone's going to have to take the certification course to use the DaVinci outside of residency so it doesn't really matter how much we're exposed to it. I guess I won't worry about it then.

 

[berger911]

Thanks for your response, I swear it's like pulling teeth to get anybody to post here. All the other specialties seem so active and then you come to obgyn and you're lucky if there's 1-2 posts a day.

Anyway, back to the topic at hand, I have definitely been keeping an eye out for vag. hyst. #s, but not so much on the lap hysts. Most places seemed to mention they had a lot of laparoscopic cases at the interview so I hadn't been worrying about it, but I will go back and have a look.

A friend of mine who is a obgyn PGY-I said almost everyone's going to have to take the certification course to use the DaVinci outside of residency so it doesn't really matter how much we're exposed to it. I guess I won't worry about it then.

🙂 leech forum. i just think it's funny how so many people posted when they were offered interview invites 🙂 people were SOO ANTSY to let the SDN world know they'll be interviewing at all the top programs, then POOF... no more posts only views!

 

[LoveSparkle]

In the programs I visited that had davinci's, when the residents were involved in the case it was mostly side stuff (not sitting on the machine). One program told me that if a resident is very interested in getting trained, there are opportunities and you can pursue it (whatever that means....)!

My overall impression is having a davinci is nice for a program to boast about, and in some rare situations residents will get a chance to do cases on it. But for the most part attendings are still learning themselves (with a few exceptions), so I don't think it changes resident training.

 

[Colonsay]

I actually think it hurts resident training, because you're spending that time as the bedside assistant that you would otherwise spend doing the case.

 

[Requiem4Souless]

In very few residencies will you get enough robotics experience to be proficient or get certified. Unless you're looking into one of the rare programs with a training console and a good program to teach residents, the experience you get will be minimal and won't translate to a marketable skill when you're on the job hunt. I wouldn't let a lack of robotics training influence my decision on ranking residency programs unless two programs are otherwise equivalent and you need a deciding factor.