Colorectal cancer is a common disease, and in Denmark about 3,400 people are diagnosed with colorectal cancer each year. Surgical removal of the cancer is one of the cornerstones of treatment, and there is an increase in the number of robotic-assisted operations.

To meet a greater need for surgeon training and to develop training opportunities, we have developed a 3D printed phantom, based on patient scans, to train robotic surgical removal of the right part of the colon.

Objective
The PhD project investigates whether it is possible to perform reliable competence assessments of surgeons when performing an advanced robotic surgical procedure for colon cancer. Furthermore, it is investigated whether the competence assessment performed in the simulated environment is consistent with the surgeon's performance during real operations,

The researchers behind the project are also looking at the following

• What basic surgical skills a robotic surgeon should have
• What assessment tools are available to assess this, whether the assessment tools are reliable
• Whether the assessment tools can be used to identify a learning need in the individual surgeon

The PhD project is carried out as a collaboration between Kolding Hospital in the Southern Region and CAMES. The PhD student carrying out the project is: Peter Hertz, Reserve Physician, Organ Surgical Department, Lillebølt Hospital, Kolding Hospital. PhD student at the Department of Regional Health, University of Southern Denmark.

Contact:

Peter Hertz, PhD student - hertz.peter@gmail.com. Read bio

Example from the lab - setup for colon cancer study

The PhD project is about investigating the non-technical skills of the robotic surgical team.
The robotic surgical team differs from other health professional teams in that one of the team members - the surgeon - is physically separated from the rest of the team and the patient bed. This affects teamwork, including coordination. Among other things, the team does not have eye contact with the surgeon during the operation, who also cannot see the operating theatre, but only the video screen with the operating field.

We examine and compare how the experienced and inexperienced robotic surgical teams coordinate their work to optimize teamwork and patient safety. Team coordination has an impact on workflow and on the risk of errors during surgery. Training teamwork can reduce errors and increase patient safety

The project contributes to the development of the Capital Region's robotic surgery training, where teamwork is trained to increase patient safety in both routine and emergency situations.

The PhD students carrying out the project are: Doctor Jannie Lysgaard Poulsen, who is a PhD student at the University of Copenhagen and at the Copenhagen Academy for Medical Education and Simulation at Herlev Hospital.

Contact: 

Jannie Lysgaard Poulsen, PhD student and doctor - Mail: jannie.lysgaard.poulsen@regionh.dk. Read bio

Prostate cancer is one of the most common cancers worldwide, accounting for about 15% of cancer diagnoses in men.

For localised prostate cancer, many people have a robot-assisted radical prostatectomy. It aims to achieve cancer control while maintaining continence and potency. These patient outcomes are highly dependent on the surgeon's level of experience both in general, but also on the day itself.

The experience level of surgeons is generally described in terms of the number of operations performed to date, but this does not tell us anything about how the surgeon performs each operation. It may therefore be difficult at this stage to predict patient outcomes for individual patients.

Robotic surgery now makes it easier to follow the surgeon's movements and actions during the operation. These are automatically recorded by the robot, and new research suggests that this data can be used to predict patient outcomes.

The PhD project investigates. Whether we can predict both short-term and long-term patient outcomes in men who have undergone robot-assisted radical proctomy using the surgeon's movement patterns pg actions.
The project is carried out as a collaboration between the Urological Research Unit / Copenhagen Prostate Cancer Center and the Copenhagen Academy for Medical Education and Simulation.

Rikke Groth Olsen, PhD student at the University of Copenhagen and Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

Contact:

Rikke Groth Olsen, MD, PhD student, rikke.groth.olsen@regionh.dk. Read bio

Robotic-assisted heart surgery performed through small holes in the chest using a robot is a more gentle surgical method than traditional "open" heart surgery. Despite its advantages, the method is slowly spreading around the world.

One of the reasons is the lack of training and competence assessment of cardiac surgeons in robotic surgery.
In the PhD project, the researchers want to validate a concrete competence assessment method for robot-assisted cardiac surgery. An international panel of robotic surgery experts has been assembled to help establish expert standards for competency assessment of new robotic surgeons. Next, the amount of training required to achieve expert level for new robotic surgeons in a simulated environment will be investigated.

Aims and objectives: 

The results of the study will help establish competency-based training for cardiac surgeons, so that we can also implement this new and more gentle surgical method in Denmark. In addition, the study will generate new knowledge on how to design models that can be used for training without involving real patients.

Cooperation

The project is the result of a collaboration between European experts in robotic-assisted cardiac surgery (Belgium, the Netherlands, Spain, Czech Republic), cardiac surgery specialists (Denmark) and medical education researchers (Copenhagen Academy for Medical Education and Simulation and Western University, London Health Sciences Center, Canada). The project is carried out at Aalborg University Hospital.

The PhD students carrying out the project are: Gennady V. Atroshchenko, Specialist in Thoracic Surgery, Department of Cardiothoracic Surgery, Aalborg University Hospital.
PhD student at the Department of Clinical Sciences and Aalborg University.
Responsible for research and course management in robot-assisted cardiac surgery, ROCnord, Aalborg.

Contact

Gennady V. Atroshchenko, Specialist in Thoracic Surgery, MD, PhD student. Read bio

Robotic surgery is increasingly used - both in Denmark and abroad. With the introduction of new technology also comes a need for training and continuous assessment to ensure safety in treatment.

So far, competence assessment has been based on expert surgeons' assessment of the skills of future surgeons. Artificial Intelligence (AI), on the other hand, represents a new way of assessing competence and may ensure that future surgeons acquire the necessary skills before operating independently.

In a national collaboration between Aalborg University Hospital and CAMES, a multidisciplinary team of doctors and engineers will use artificial intelligence to develop competence assessment tools for robotic surgeons. This could reduce errors and increase the quality of robot-assisted kidney surgery.

PhD student conducting the project is Nasseh Hashemi, MD
PhD student at the Department of Clinical Sciences, Aalborg University and Nordsim, Center for Skills Training and Simulation and ROCnord, Aalborg 

Contact: 

Nasseh Hashemi, MD, PhD student, Mail: n.hashemi@rn.dk Read bio.