Assessing Robotic Surgical Competence in Colorectal Surgery: MGEARS Scores Are Independent of Overall Case Volume

Objective: Robotic case volume is a widely used surrogate for robotic proficiency in literature and in practice. The aim of this study is to determine if case volume correlates with the Modified Global Evaluative Assessment of Robotic Skills (mGEARS) scores in colorectal surgery. Design: A cross-sectional observational study assessing robotic skills through a simulated ex vivo side-to-side intracorporeal stapled anastomosis on a porcine model was performed. mGEARS scores were determined by 3 blinded expert reviewers. Setting: Simulation sessions using the Da Vinci Xi™ platform, were conducted during the Orlando Colorectal Congress 2022 in Orlando, Florida, United States of America. Participants: Twenty surgeons (18 men, 2 women) attending the conference volunteered to participate. Surgeons were defined as high overall volume surgeons and low overall volume surgeons based on overall case volume of ≥100 or <100 cases, respectively. Results: Ten surgeons (50%) had case volume of >100 robotic cases. Number of intracorporeal anastomoses done by subjects was correlated with reviewers’ assessment of efficiency ( P = .02, Spearman’s coefficient = 0.5) and total mGEARS score ( P < .001, Spearman’s coefficient = 0.59). However, there was no significant difference in total mGEARS score or any of its individual components between high overall volume surgeons and low overall volume surgeons. Conclusions: mGEARS scores of intracorporeal anastomosis done by colorectal surgeons were not correlated with overall robotic case volume. Also, specific experience in intracorporeal anastomosis was associated with higher mGEARS scores noted in this specific procedure. Establishment of a fundamental robotic surgical skills examination is warranted.