Education and Training

The Cutting Edge: Training Students in Robotic Surgery

KPSOM acquires da Vinci Surgical System in gift from Kaiser Permanente West Los Angeles Medical Center

November 27, 2023

KPSOM Founding Dean and CEO Mark Schuster speaks at the da Vinci Surgical System commemoration.

Students at the Kaiser Permanente Bernard J. Tyson School of Medicine (KPSOM) will soon have opportunities to learn minimally invasive robotic surgery techniques, thanks to the donation of a da Vinci Surgical System from Kaiser Permanente West Los Angeles Medical Center.

“The da Vinci robot is a great addition to our school’s Simulation Center, and I can’t thank our West Los Angeles Medical Center enough for this wonderful gift,” said Mark Schuster, MD, PhD, Founding Dean and CEO. “Our students, especially those considering going into surgery, now have another terrific learning tool to use in developing their skills.”

The da Vinci unit arrived at KPSOM in November and is currently in the process of being fully set up. The machine will offer students the opportunity to learn basic robotic surgery techniques, giving them a foundation to continue learning more complex procedures if they choose to pursue residency training in a surgical field where robot-assisted surgery is used in procedures such as nephrectomy, prostatectomy, hysterectomy, cholecystectomy, hernia repair, bowel surgery, and more, school officials said.

The da Vinci unit was in service for approximately 8 years, Kirk Tamaddon, Kaiser Permanente Area Medical Director, said at a recent event commemorating the donation to KPSOM. West Los Angeles Medical Center has been at the leading edge of this technology within the Kaiser Permanente system, becoming the first medical center to perform robotic surgery in 2008, and later, the first to have two robotic surgery machines.

(Left to right) Ije Nwosu, Dr. Jennifer Nguyen, Nancy Spiegel, Lourdes Valdez, Lilit Zibari, Dr. Kirk Tamaddon, Dr. Mark Schuster, Dr. Ashish Parekh, Moe Aboufares, and Dr. Candace Pau cut a ribbon in celebration of Kaiser Permanente West Los Angeles Medical Center’s donation of the da Vinci Surgical System to KPSOM.

“Our perioperative surgical teams have utilized this robot thousands of times, to help cure and improve the lives of thousands of patients through minimally invasive robotic approaches that involve less blood loss, less pain and suffering,” Tamaddon said. “And we’re hoping that the next generation of future physicians will benefit and really take this to the next level, whether as practicing physicians or as future designers of new [robotic surgery] systems. It’s really with pleasure, and an honor, that we present this gift to our medical students and our medical school.”

The da Vinci system’s ergonomics, multiple arms, and laparoscopic-based system enable surgeons to perform complex operations via small incisions. The benefits to patients can also include faster recovery, minimal scarring and pain, and shorter hospital stays, Tamaddon said.

Development of the robotic surgery curriculum is still in its early phases, but the technology will be accessible to all KPSOM students who are considering becoming surgeons, and even those who aren’t, said Candace Pau, MD, Faculty Director of Simulation.

“For students who are definitely interested in going into a surgical specialty, who will use this type of robot in their future practice, it makes a lot of sense for them to get some exposure, so they’ll really be ahead of the game when they start their residency training,” said Pau. “And we’re interested in exploring places in the curriculum where it could be helpful for students earlier on in their training to interface with the robot, such as in preparation for their surgery clerkship rotations.

“Walking into an operating room, there’s this big machine with all these arms. What does it do? That’s the whole premise of our Simulation Center, to help students not only have the skills and the chance to practice these procedures, but also to have the confidence that comes with familiarity with the technology and the environment.”

KPSOM’s robotic surgery curriculum will be supported by Ashish Parekh, MD, KPSOM Clinical Assistant Professor of Clinical Science and a practicing Urologist with Kaiser Permanente. Parekh has performed more than 1,000 robotic surgical procedures, many on the same machine that is now at the school.

Early training will likely involve simulation-only scenarios in which students will work on the console and learn how to use the applications that run the robot, but the robotic arms and instruments will not be utilized; the simulation will be entirely virtual, like a video game, Parekh said. A second phase of training will likely involve placing trocars and inserting the robot arms into one of the Simulation Center’s full-patient mannequins, a process called “docking,” and further simulating actual surgeries.

Dr. Ashish Parekh demonstrates the da Vinci Surgical System during the robot’s commemoration in the KPSOM Simulation Center.

Future doctors who’ve grown up with access to video games and other modern technology tend to be comfortable with the technology, but training is key, Parekh said.

“We’ve been training residents on the robot for the better part of 15 years at the medical center, and we’ve definitely learned a couple things,” Parekh said. “They do have those skills, and they can adapt to having visual cues rather than tactile sensations while doing surgery. But they still need anatomic knowledge. They still need guidance on where the pitfalls are because, of course, it’s a human body … They’re keenly aware that there’s a human being that they’re [performing surgery on]. They don’t treat this like a video game.”

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