Procedural robotic surgery training: a UK pan-specialty trainee Delphi consensus study

Abstract

Robotic surgery has become increasingly prevalent in the UK, with 65% of the population living within a 30-min drive of a robotic surgical centre. However, many surgical trainees lack access to structured robotic training, highlighting the need for standardised pathways to equip future surgeons. This study seeks to determine a consensus amongst UK surgical trainees on the opinion of essential components of procedural robotic training. A trainee-led Delphi consensus study was conducted with 85 surgical trainees representing the spectrum of surgical specialism and training grades. A steering group consisting of a surgical expert and trainee representatives developed and refined statements across key themes, including robotic curricula, credentialling structure, assessment standards, error metrics and access to training. Trainee feedback was collected through three iterative survey rounds, with consensus defined as ≥ 80% agreement or disagreement. Consensus was achieved for 82 of 141 statements. Trainees strongly supported the integration of robotic training into surgical curricula, emphasising the importance of metrics-based assessment and credentialling in device, basic and procedural training. Key recommendations included platform-agnostic training, benchmarking, proficiency-based progression, and video-based assessments for procedural skills. Additional endorsements included revalidation every 5 years and centralised registries for robotic cases. Flexible access to training, beginning at higher specialty levels, was also advocated. This study establishes a robust consensus amongst UK surgical trainees, highlighting the acceptability of credentialling in robotic surgery. The findings provide a framework for developing equitable and standardised robotic training pathways to ensure the preparedness of future surgeons in an evolving surgical landscape.