A two-round international Delphi process (n=83 invited, 71 completing round 1) plus a hybrid consensus meeting was used to build agreement on a platform-agnostic robotic surgery training curriculum for gastrointestinal (GI) and visceral surgical trainees, covering knowledge requirements, training components, performance assessment, and certification.
Round 1: 82/106 items (77%) reached consensus (≥70% scoring 7–9); round 2: 36/56 items (64%) reached consensus. A final 57-statement curriculum was agreed upon across four domains: knowledge requirements for bedside assistant and console surgeon, training components (e-learning → simulation → bedside assisting → supervised console), performance assessment (case logs, GEARS, procedure-specific CATs, video assessment), and certification/supervision (proctor sign-off with stepwise progression in increasing case complexity).
- Panel skewed toward UK (35%), Italy (23%), and Spain (11%), limiting generalisability to Eastern/Northern Europe and low- and middle-income countries. - Panel largely comprised early adopters with >50 independent robotic cases, risking bias toward resource-intensive training assumptions. - Consensus reflects primarily European context; wet-lab access, standardised assessment tools, and dedicated proctoring may not be universally available.
GI surgery programs should structure robotic training as a stepwise progression—e-learning, simulation (virtual/dry/wet lab), bedside assisting, then supervised console time—with trainee sign-off based on objective tools (GEARS, CATs, video assessment) and clinical outcome data rather than case numbers or hours alone. Fellowship completion was considered desirable but not mandatory, given limited availability.
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