The impact of standardized robotics course training during colorectal surgery fellowship on post-training practice: a survey of graduates

The Association of Program Directors for Colon and Rectal Surgery (APDCRS) has sponsored a standardized robotics course for colorectal and minimally invasive surgery fellows since 2011. The study objective was to assess the impact of the APDCRS-sponsored course on surgical approaches adopted by young colorectal surgeons before, during, and after fellowship. An internet-based survey was administered to 2014-2022 ACGME-accredited colorectal surgery program graduates. Study variables were summarized using frequencies and proportions. Survey response rate was 43.2%. Laparoscopic and robotic volumes were consistently higher than open and hand-assist laparoscopic volumes over the study period. About 70.0% of fellows performed ≥ 20 laparoscopic cases before 2017, and over 80% had experience with ≥ 20 laparoscopic cases during/after 2017. An increasing trend of performing ≥ 20 robotic colorectal cases during fellowship was observed (before 2017: 75.0%, 2018-2019: 76.9%, and 2021-2022: 84.8%). Multivariate logistic regression analysis showed that higher robotic volume (≥ 25 colorectal cases) during general surgery residency increased odds of performing ≥ 50 robotic cases during fellowship (OR: 4.38, 95% CI 0.88, 26.1). Higher robotic volumes during fellowship correlated with higher robotic volumes in the first year of post-fellowship practice. 88.6% of respondents agree (21.0%) or strongly agree (67.6%) that the APDCRS robotics training course met expectations, and 83.8% agree or strongly agree that the course prepared them for post-graduate robotics practice. The APDCRS-sponsored robotics training course met expectations and prepared colorectal surgery fellows for adopting the robotic approach after graduation, with the majority of respondents reporting that they utilize robotics in their post-graduation colorectal practice.