Resident training experience with robotic assisted transabdominal preperitoneal inguinal hernia repair

Am J Surg. 2020 Feb;219(2):278-282. doi: 10.1016/j.amjsurg.2019.11.014. Epub 2019 Nov 11.


Background: General surgery is the fastest growing field in the adoption of robotic assisted laparoscopic surgery. Here, we present the results of one institution's experience in training surgical residents in robotic assisted transabdominal preperitoneal inguinal hernia repairs.

Methods: Data were prospectively collected on patients undergoing robotic assisted laparoscopic inguinal hernia repair with residents. Data points included patient age, gender, complications, hernia difficulty, resident technical competency as measured by GEARS, Zwisch scores, operative time, and the number of robotic console cases reported by residents as primary surgeon.

Results: Residents who performed >30 robotic cases had significantly higher mean modified GEARS scores (p ≤ .002). Residents who completed 10 or fewer robotic cases achieved significantly lower mean modified GEARS and Zwisch scores than those who completed 11 or more (p < .001).

Conclusions: Resident competency and autonomy improve with increasing total robotic case load. Attending surgeons grant more autonomy to residents with higher competency scores.

Keywords: Inguinal hernia repair; Robotic surgery; Transabdominal preperitoneal repair.

MeSH terms

  • Adult
  • Analysis of Variance
  • Clinical Competence*
  • Databases, Factual
  • Education, Medical, Graduate / methods
  • Female
  • Hernia, Inguinal / surgery*
  • Herniorrhaphy / education*
  • Herniorrhaphy / methods
  • Humans
  • Internship and Residency / methods
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Professional Autonomy*
  • Retrospective Studies
  • Robotic Surgical Procedures / education*
  • Robotic Surgical Procedures / methods
  • Statistics, Nonparametric
  • Surgical Mesh
  • Treatment Outcome