By Myriam Curet, Executive Vice President and Chief Medical Officer of Intuitive and a practicing surgeon
As the global health care infrastructure steadies itself in the wake of Covid-19, it reminds me about how much has changed from the first time I stepped into an operating room more than 30 years ago.
The digitization of information, the integration of technology, and the introduction of new practices have fundamentally changed how care is delivered. As we’ve all coped with the pandemic, the nature of how we work together has changed too. Surgeons like me have been looking for and adopting more innovative ways to keep our skills nimble in order to better serve patients with these new technologies.
Despite the upheaval of this year, several factors remain constant within the foundational principles of health care: the importance of patient-focused care, the effectiveness of an integrated care team, and the vital role training and education plays for health care professionals.
This last element is all the more important as new tools and technologies get introduced into the practice and delivery of medicine. In the operating room, the introduction of robotic-assisted tools and technologies is an evolution that I have been a part of both as a practicing surgeon and chief medical officer of Intuitive.
A growing body of independent, peer-reviewed research (more than 21,000 published studies, at last count)1 demonstrates that minimally invasive, robotic-assisted surgery can offer patients benefits, including less blood loss, fewer complications, less time in the hospital, and less chance of readmission compared with open surgery,2 depending on the procedure.
When I think about the practical advantages of robotic-assisted surgery, I think of my bariatric patients who often have thick abdominal walls, which presented something of a physical challenge for me in open or laparoscopic procedures before I began using robotic tools.
Robotic-assisted systems, tools and technologies helped overcome these issues, enabling me to be an even more effective surgeon for my patients.
But — as with any surgical modality — I had to first learn how to safely and effectively use those tools. Without proper training and education to support surgeons and operating room teams, even the most innovative technology will be of limited value to patients.
That’s why Intuitive has moved to quickly adapt its technology training pathway to accommodate surgeons adjusting to the pandemic. Our training infrastructure includes 140 academic centers3, 290 fellowship training sites, and 8,400 surgeons who utilize da Vinci systems at those sites4. We’ve trained more than 52,000 surgeons globally5, giving them a broad array of simulation tools to help them master the use of our products.
This robust training infrastructure provided critical resources to surgeons and care team professionals during the period where hospitals and medical centers weren’t performing elective surgeries. The virtual components of training — online classes and peer support — helped many surgeons keep their skills sharp while they couldn’t conduct surgeries. And since elective procedures have resumed, we’ve moved our training efforts closer to our customers to limit travel and maximize convenience for surgeons and care teams.
I train surgeons as a part of my practice, and I feel improved learning comes from listening to surgeons and care team members as they experience our products and services. That feedback loop informs our next generation of training so we can continue to help health professionals gain the confidence they need with our technology.
That approach keeps Intuitive continuously improving how we train on the technology. For surgeons and care team professionals, we offer relevant training for as long as they use Intuitive systems, giving them the choice to learn through videos on their own time, through peer-to-peer mentoring, or intensive master-level classes. Our training differentiates the Intuitive experience and updating our program to keep the training relevant for surgeons is a challenge that I take personally, whether I’m in the operating room or in the office.
Training is a journey, not a destination. As a surgeon and chief medical officer at Intuitive, I seek to continuously improve my knowledge and techniques. That is my commitment to myself, my patients, and my fellow surgeons and their teams.
The robotic cohorts of references 1, 2, and 3 show significantly longer operative times than the open and/or laparoscopic cohorts. Data are not case-matched for patient demographics; results may change in a matched population.
All other reported outcomes, such as demographic, complication and conversion data, do not show statistical difference between the respective cohorts. Readers should review the complete publications for study limitations.
1 Geppert B, Lönnerfors C, Persson J. “Robot-assisted laparoscopic hysterectomy in obese and morbidly obese women: surgical technique and comparison with open surgery.” Acta Obstet Gynecol Scand. 90.11 (2011): 1210-1217. doi: 10.1111/j.1600-0412.2011.01253.x. Epub.
2 Lim, Peter C., John T. Crane, Eric J. English, Richard W. Farnam, Devin M. Garza, Marc L. Winter, and Jerry L. Rozeboom. “Multicenter analysis comparing robotic, open, laparoscopic, and vaginal hysterectomies performed by high-volume surgeons for benign indications.” International Journal of Gynecology & Obstetrics3 (2016): 359–364. Print.>
3 Martino, Martin A., MD, Elizabeth A. Berger, DO, Jeffrey T. McFetridge, MD, Jocelyn Shubella, BS, Gabrielle Gosciniak, BA, Taylor Wejkszner, BA, Gregory F. Kainz, DO, Jeremy Patriarco, BS, M. B. Thomas, MD, and Richard Boulay, MD. “A Comparison of Quality Outcome Measures in Patients Having a Hysterectomy for Benign Disease: Robotic vs. Non-robotic Approaches.” Journal of Minimally Invasive Gynecology 21.3 (2014): 389-93. Web.