Journal of the European Society for Gynaecological Endoscopy


Recommendations for a standardised educational program in robot assisted gynaecological surgery: Consensus from the Society of European Robotic Gynaecological Surgery (SERGS)

P. Rusch 1* , T. Ind 2,3 , R. Kimmig 1 , A. Maggioni 4 , J. Ponce 5 , V. Zanagnolo 4 , P.J. Coronado 6 , J. Verguts 7,8,4 , E. Lambaudie 9,10 , H. Falconer 11 , J.W. Collins 12 , R.H.M. Verheijen 13

1 Department of Obstetrics and Gynaecology, University Hospital Duisburg-Essen; Hufelandstr. 55, 45147 Essen, Germany. Email: Email:;
2 Department of Gynaecological Oncology, The Royal Marsden, London, UK;
3 St George’s University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London, Email:;
4 Division of Gynaecology, European Institute of Oncology, Via Ripamonti, 435, 20141 Milano, Italy. Email: Email:;
5 Department of Gynaecological Oncology, Hospital Universitari de Bellvitge, c/ Feixa Llarga, sn, 08907 L’ Hospitalet de Llobregat. Barcelona, Spain. Email:;
6 Department of Gynaecological Oncology, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Avda. de Séneca, 2, Ciudad Universitaria, 28040 Madrid, Spain. Email:;
7 Department of Obstetrics and Gynaecology, University Hospitals Leuven, 3000 Leuven, Belgium;
8 Department of Obstetrics and Gynaecology, Jessa Hospital, 3500 Hasselt, Belgium, Email:;
9 Department of Gynaecologic Oncology, Centre de Lutte Contre le Cancer Oscar Lambret, 3 Rue Frédéric Combemale, 59000 Lille, France;
10 Aix Marseille Université, Site Timone, Timone 27, boulevard Jean Moulin, 13385 Marseille cedex 5, France. Email:;
11 Department of Women’s and Children’s Health, Division of Obstetrics and Gynecology, Karolinska Institutet/University Hospital, 171 76 Stockholm, Sweden. Email:;
12 Department of Urology, Karolinska University Hospital, Karolinska Universitetssjukhuset, Solna, D1:01 171 76 Stockholm, Sweden. Email:;
13 Department of Gynaecological Oncology, UMCU Cancer Center, University Medical Center, Utrecht, Netherlands. Email:


Delphi; training; robot assisted surgery; consensus

Published online: Oct 03 2019


Background: The Society of European Robotic Gynaecological Surgery (SERGS) aims at developing a European consensus on core components of a curriculum for training and assessment in robot assisted gynaecological surgery.

Methods: A Delphi process was initiated among a panel of 12 experts in robot assisted surgery invited through the SERGS. An online questionnaire survey was based on a literature search for standards in education in gynaecological robot assisted surgery. The survey was performed in three consecutive rounds to reach optimal consensus. The results of this survey were discussed by the panel and led to consensus recommendations on 39 issues, adhering to general principles of medical education.

Results: On review there appeared to be no accredited training programs in Europe, and few in the USA. Recommendations for requirements of training centres, educational tools and assessment of proficiency varied widely. Stepwise and structured training together with validated assessment based on competencies rather than on volume emerged as prerequisites for adequate and safe learning. An appropriate educational environment and tools for training were defined. Although certification should be competence based, the panel recommended additional volume based criteria for both accreditation of training centres and certification of individual surgeons.

Conclusions: Consensus was reached on minimum criteria for training in robot assisted gynaecological surgery. To transfer results into clinical practice, experts recommended a curriculum and guidelines that have now been endorsed by SERGS to be used to establish training programmes for robot assisted surgery.