REVIEW
J. Abdom. Wall Surg.
Structured Training in Robotic Abdominal Wall Surgery: A Systematic Review of Educational Models, Methodologies, Existing Gaps and Unmet Needs
- FB
Francesco Brucchi 1,2,3
- AD
Annabelle De Troyer 4
- AG
Alice Gori 2,5
- GD
Gianlorenzo Dionigi 6,7
- EV
Eva Vanderstraeten 2
- AM
Alexander Mottrie 2
- IV
Isabelle Van Herzeele 2,8
- NR
Niki Rashidian 2,9
- FM
FILIP MUYSOMS 3
1. University of Milan, Milan, Italy
2. ORSI Academy asl, Melle, Belgium
3. AZ Maria Middelares vzw, Ghent, Belgium
4. Department of Surgery, ZAS, Antwerp, Belgium
5. Universita degli Studi di Bologna, Bologna, Italy
6. Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
7. Universita degli Studi di Milano Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti, Milan, Italy
8. Department of Thoracovascular Surgery, Ghent University Hospital, Ghent, Belgium
9. Department of General, HPB Surgery, and Liver Transplantation, Ghent University Hospital, Ghent, Belgium
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Abstract
Background: Robotic-assisted abdominal wall surgery demands advanced technical proficiency. The advent of robotic platforms has driven the development of various training approaches, including simulation-based modules, animal models, and structured curricula. This systematic review critically assesses current training strategies and models, comparing their effectiveness in skill acquisition through validated assessment tools and evaluating their implementation from a cost-effectiveness perspective.Methods: A comprehensive search of the scientific literature was conducted across three major databases (PubMed, Embase, Cochrane, Google Scholar) up to April 2025. The study was registered in PROSPERO (CRD420251027155) and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were selected based on inclusion of robotic training programs related to abdominal wall surgery.Results: Out of 3,038 records identified, 8 studies were included. The overall methodological quality was acceptable, with all studies showing moderate risk of bias. Training models varied and included virtual reality simulation (n=4), inanimate models (n=3), porcine models (n=2), and intraoperative training (n=4). Three studies described integrated, proficiency-based curricula. Skill acquisition was reported using validated tools such as GEARS, OSATS, or the Zwisch scale in only two studies. Reported costs ranged from €40 for silicone models to €600 for porcine models; one study demonstrated $1,207 in cost savings per case post-training.Current training models for robotic-assisted abdominal wall surgery are heterogeneous in design, assessment methods, and cost. While integrated curricula show promise, few studies employ validated tools to evaluate skill acquisition. Further high-quality research is needed to standardize training approaches and assess their cost-effectiveness.
Summary
Keywords
robotic-assisted surgery, abdominal wall surgery, Proficiency-based training, Surgical training, Structured curricula
Received
29 June 2025
Accepted
08 August 2025
Copyright
© 2025 Brucchi, De Troyer, Gori, Dionigi, Vanderstraeten, Mottrie, Van Herzeele, Rashidian and MUYSOMS. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Francesco Brucchi, brucchi.francesco@gmail.com
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.