О 8 О DOI: http://doi.org/10.30978/CEES-2020-4-8 Clinical Endocrinology and Endocrine Surgery / Клінічна ендокринологія та ендокринна хірургія 4 (72) 2020 ORIGINAL RESEARCH / ОРИГІНАЛЬНІ ДОСЛІДЖЕННЯ UDK 616.33-089.87-089.819 INTRODUCTION The utilization of robotic surgery has exponentially increased over the past decade [1]. The robotic platform overcomes limitations that are associated with laparoscopic surgery [2]. The technological innovations of the robotic platform help improve surgeon ergonomics and the surgical outcomes; such as, but not limited to, reduced blood loss and length of hospital stay [3]. Standardized training in robotic surgery has become necessary due to the increased demand which has led to the development of different robotic surgery curricula. There are curricula that offer basic training through online self-paced portals, such as the da Vinci Technology Training Pathway and Fundamentals of Robotic Surgery (FRS). On the other hand, the Fundamental Skills of Robot-Assisted Surgery (FSRS) training programs and the Robotics Training Network offer a more sophisticated form of hands-on training [1]. The use of the robotic technology in general surgery has expanded to numerous subspecialties, along with an increased exposure to surgical residents and development of fellowship programs that are focused on robotic assisted procedures [4]. Since its original establishment in the 1950’s, bariatric surgery has emerged as a successful modality in the treatment of morbid obesity. Bariatric surgery became more popular due to better outcomes on weight loss, hyperglycemia control, hyperlipidemia, hypertension, cardiovascular risk, and mortality compared to medical therapy [5, 6]. The two commonly performed procedures are laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y-gastric bypass (RYGB) [7]. Bariatric surgery is technically complex and requires a superb understanding of anatomical landmarks and key steps of the procedures to prevent morbidity and mortality. There have been numerous studies involving residents and fellows showing variable results with most of them being negative. The affects seen are primarily based on prolonged operative duration [8]. With newer DaVinci Xi model and vessel sealer, sureform stapler, the comprehensive learning of individual steps of surgery is seamless for the residents. Utilization of laparoscopic technique remains challenging in morbidly obese patients due to the rigidity of instruments and poor ergonomics. Robotic surgery has become an alternative approach which often provides a shorter learning curve compared to laparoscopy, due to improved dexterity, precision, and 3-D visualization [9]. There are studies comparing laparoscopic and robotic vertical sleeve gastrectomy (RVSG) that have demonstrated comparable outcomes between the two approaches. RVSG demonstrates a shorter learning curve compared to laparoscopy in approximately 20 cases [8, 10]. Chandra Hassan MD, FACS, Yevhen Pavelko MD, Stephan Gruessner MD, Valentina Valle MD, Antonio Gangemi MD, FACS, Francesco Bianco MD, FACS, Pier Giulianotti MD, FACS UI Health-Division of General, Minimally Invasive & Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 820 South Wood Street, Rm 609, Clinical Sciences North Chicago, Chicago, IL, 60612, USA Totally robotic sleeve gastrectomy as a training model for residents and fellows Yevhen Pavelko, MD, Clinical Research Specialist, Fellow Department of Surgery UI Health — Division of General, Minimally Invasive & Robotic Surgery University of Illinois at Chicago. 820 South Wood Street, Rm 609, Clinical Sciences North, Chicago, IL 60612. Office: (312) 413-0886, Cell: (847) 714 -6680. E-mail: ypavelko@uic.edu. Phone: +1 847-714-6680