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Robotic Surgery - Endorsement & Accreditation by TROGSS

From Standards to Accreditation: #surgicaleducationforall

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Introduction

These guidelines provide a standardized framework for developing, implementing, and accrediting robotic surgery training courses. They are designed to ensure patient safety, surgical proficiency, and equitable access, particularly in low- and middle-income countries (LMICs). Synthesized from global best practices, including recommendations from the Robotic Surgery Education Working Group 0 , SAGES/MIRA consensus 3 29 , STS expert consensus, IMRA/SRS Delphi consensus, BAUS guidelines 8, and AUA best practices, they address heterogeneity in training to reduce variability in outcomes by up to 50-70%. Courses accredited by TROGSS must meet these criteria for international recognition and credential portability.

The Challenge

Why Robotic Education Needs Standardization

Robotic surgical training has evolved without a unified standard. It began as proprietary education delivered by manufacturers, later adapted by hospitals, individual surgeons, and private organizations with their own methods and incentives. This has created inequality in access and inconsistency in quality across the world.

Key Challenges
  • Limited access to robotic platforms, simulators, operating rooms, and patient cases.
  • Financial and scheduling barriers that restrict participation, especially in emerging markets.
  • Fragmented curricula designed by different institutions or vendors without universal benchmarks.
  • Variable quality control and absence of standardized outcomes or certification metrics.
  • Geographic inequality — surgeons in lower-resource settings often lack exposure or opportunity.
  • Slow innovation uptake due to lack of formalized frameworks for training and recertification.
TROGSS Education: Our Promise

Develop and maintain a Global Robotic Competency Framework (GRCF) — platform-agnostic and evidence-based.

  • Publish standardized criteria for the design and evaluation of robotic training courses.
  • Offer the TROGSS Accreditation seal after evaluation by the Global Council of Experts & Education Committee.
  • Ensure that every student completing a TROGSS-accredited course becomes an automatic TROGSS member, strengthening the society’s global educational presence.
  • Use this membership community’s feedback to evolve standards continuously.
  • Integrate AI-driven adaptive learning and data insights to improve efficiency and accessibility in training.
  • Partner with global academic institutions and medical societies to make robotic education more equitable.
Why a Global Standard Matters — Backed by Research

The IMRA/SRS Delphi consensus (2024) identified lack of access and absence of standard curricula as major global issues.

  • A systematic review (2023) found substantial heterogeneity in robotic training methods, outcomes, and resources.
  • ERUS and FRS frameworks have validated that structured, proficiency-based curricula improve learning efficiency and safety outcomes.
  • Educational robotics literature (2022–2025) highlights access, instructor capacity, and infrastructure as global barriers and supports standardization efforts (Ryalat et al., Research and Education in Robotics; Lu et al., Nature Communications, 2025).
  • Cross-specialty studies emphasize the potential of AI and adaptive simulation tools to personalize robotic education while maintaining quality benchmarks.
  • The TROGSS CARS (Competency-Based Assessment of Robotic Surgery Skills) Rubric and Curriculum demonstrates the advantages of supervised surgical education with objective measurement of 10 competencies or required skills to become proficiency in robotic surgery regardless of the specialty or procedure.

Together, these findings support the establishment of TROGSS as the neutral, surgeon-led authority for robotic education and accreditation worldwide.

Phase 1: Planning and Program Development

Define Scope and Objectives

Specify learning outcomes for technical skills (e.g., instrument manipulation), non-technical skills (e.g., team communication), and platform-specific knowledge (e.g., da Vinci, Versius). Tailor to trainee levels: novice, intermediate, or advanced.

Needs Assessment

Evaluate resources, trainee demographics, and institutional capabilities. Incorporate hybrid models (e.g., virtual simulation) for LMICs to enhance accessibility.

Multidisciplinary Team

Assemble surgeons, nurses, anesthesiologists, educators, and engineers. Designate a Robotics Team Leader to oversee compliance.

  • Regulatory Compliance: Align with local and international standards (e.g., FDA, CE Mark, NMPA) and include ethical training on data privacy and telesurgery.
  • Resource Allocation: Secure simulators, cadavers/animal models, and digital tools. Minimum requirement: One robotic system per 4-6 trainees.

Phase 2: Curriculum Design

1. Modular Structure

Organize into five progressive modules:

  1. Fundamentals (didactic on robotics principles);
  2. Simulation Training (VR/box trainers);
  3. Bedside/Console Proficiency (docking, controls);
  4. Procedure-Specific Skills (e.g., prostatectomy);
  5. Advanced Integration (crisis management).
2. Duration and Intensity
  1. Minimum 40-60 hours for basic certification;
  2. 6-12 months for fellowships, including 20-50 supervised cases.
3. Inclusivity and Diversity

Adapt for regional variations and include cultural competency training. Ensure equitable access through low-cost alternatives.

4. Integration

Embed within existing residency/fellowship programs to promote seamless adoption.

Phase 3: Delivery Methods

Blended Learning

Combine online lectures, lab simulations, and clinical proctoring for flexibility.

Team-Based Training

Instruct the entire OR team simultaneously, emphasizing bedside assistant roles (e.g., instrument exchange).

Hands-On Components

Require 10-15 simulator repetitions before console access; use animal/cadaver labs for realism, followed by 5-10 proctored cases.

Scalability

Offer low-cost options (e.g., open-source VR) and remote proctoring for LMICs.

Faculty Qualifications

Instructors must have 50+ independent cases and complete trainer certification workshops.

Phase 4: Assessment and Proficiency Validation

Objective Metrics

Use validated tools like GEARS or FSRS for scoring (e.g., >80% proficiency on metrics such as economy of motion).

Subjective Evaluation

Apply OSATS and 360-degree feedback from multiple evaluators.

Milestones and Accreditation

Require simulation benchmarks before clinical progression; full credentialing after 20-50 proctored cases.

  • Continuous Monitoring: Mandate annual recertification (10-20 cases/year) with AI-driven analytics for feedback.
  • Quality Assurance: Benchmark against international criteria (e.g., IMRA/SRS) and track outcomes like complication rates.

Phase 5: Evaluation, Sustainability, and Continuous Improvement

01

Program Evaluation

Conduct pre/post assessments using the Kirkpatrick model; follow up at 6-12 months on clinical performance.

02

Sustainability

Secure funding through grants, industry partnerships, or TROGSS endorsements; target <$5,000 per trainee in high-resource settings.

03

Research and Iteration

Collect data for outcomes research; update annually to incorporate new technologies (e.g., AI enhancements) and include complication management modules.

Global Harmonization: Pursue TROGSS accreditation for cross-border validity; pilot in diverse regions (e.g., Europe, Asia, Africa) for refinement.

Our Accredited Course

Robotic Surgery - Endorsement & Accreditation by TROGSS

From Standards to Accreditation: #surgicaleducationforall

  • Establishing a Global Standard for Robotic Surgical Education: TROGSS is leading the first surgeon-driven, platform-agnostic framework to unify robotic surgery training and accreditation worldwide — ensuring every trainee, regardless of geography or institution, is evaluated by consistent, evidence-based standards.
  • Empowering Institutions Through Transparent Accreditation: Hospitals, universities, and training centers can earn the TROGSS Accreditation Seal, validating curriculum quality, faculty standards, and competency-based outcomes — giving programs international credibility and visibility in the global robotic education ecosystem.
  • Building an Inclusive, Data-Driven Learning Community: Every graduate of a TROGSS accredited course becomes part of a global network of robotic surgeons and educators contributing real-world data, feedback, and innovation to continuously improve surgical education, accessibility, and safety.
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Advancing Robotic Surgery and Education, for Our Patients, by Our Surgeons

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Copyright 2025 © TROGSS

Co-Director's Message

As the newly appointed Co-Director of the Robotic Time Zone (RTZ), I am thrilled to welcome you to our vibrant and innovative community. Here at RTZ, we are more than just a network of robotic surgery enthusiasts; we are a global family united by a shared passion for advancing the surgical field and enhancing patient care through research, education, and community.

Our community is the heartbeat of medical progress. It’s where ideas are born, knowledge is shared, and breakthroughs are nurtured. At TROGSS, we offer a wealth of resources designed to fuel your curiosity and elevate your expertise. From exclusive webinars and hands-on workshops to our dynamic forums and collaborative research initiatives, RTZ offers endless opportunities to learn, connect, and innovate alongside the brightest minds in robotic surgery.

Building a strong community is at the core of what we do. Medical knowledge thrives in spaces like RTZ, where diverse perspectives come together to challenge, inspire, and grow. Whether you’re exploring our extensive library of case studies or engaging in real-time discussions with peers across the globe, you’ll find that RTZ is a place where your contributions matter and your passion finds a home.

The passion for surgery—especially robotic surgery—knows no borders. It transcends time zones, uniting us in the ever-evolving Robotic Time Zone, where innovation and excellence drive us forward. Welcome to explore and join us in this vibrant space: The Robotic Time Zone.

Warm regards,
Susana Acosta, MD
Co-Director, Robotic Time Zone
TROGSS

Co-Director's Message

As Co-Director of Robotic Time Zone, it’s my privilege to introduce you to our global platform—a space created to bring the TROGSS family together, celebrate our achievements, and share our collective knowledge. Robotic Time Zone is everything; it’s a reflection of who we are—a vibrant community of surgeons, trainees, and students driven by a shared passion for advancing robotic surgery and education.

In every edition, we’ll take you through some of the most remarkable moments from TROGSS events, showcase innovative research, share valuable tips and tricks, and dive into compelling case discussions from operating rooms, with incredible editorials on recent research on Robotics across the globe. You’ll also find stories that inspire, resources to learn from, and voices that resonate with our mission of empowering excellence.

At its core, RTZ is about connection, lifelong learning, everything you need to excel in the field of Robotics. It’s about celebrating the talent, dedication, and creativity within our society and keeping us all inspired as we work together to shape the future of surgery.

Thank you for being a part of this journey. I can’t wait for you to explore what we’ve created together.

Your Friend, 

Dr. Aman Goyal

Co-Director of Robotic Time Zone

Chair, Medical Student Committee

Director's Message

Dear TROGSS Members, Friends, and Supporters, it is with great pride and immense gratitude that I welcome you to Robotic Time Zone, a cornerstone of the TROGSS mission and a dedicated space where ideas, innovation, and connections converge. This platform is not just a means of communication—it is a sanctuary for robotic surgeons, trainees, and medical students worldwide. It is a room designed to foster knowledge exchange, fuel collaboration, and nurture the bonds of true friendship that transcend borders and disciplines.

As we launch this initiative, I envision Robotic Time Zone as much more than a section of TROGSS; it is a living, breathing ecosystem of growth and inspiration, where every conversation sparks an idea, every collaboration builds a bridge, and every achievement becomes a shared victory. It is a space where knowledge knows no boundaries, and the diversity of our global perspectives enriches the solutions we create for the future of robotic surgery.

Here, we are not limited by time zones or geographical borders. Instead, we are connected by a shared purpose and a relentless drive to push the boundaries of what is possible in surgical care. Whether it is through exchanging groundbreaking techniques, sharing lessons from challenges, or mentoring the next generation of surgeons, Robotic Time Zone is a place where we redefine the meaning of progress and excellence.

This platform is a reflection of our values: empathy, unity, and a commitment to continuous learning. It is not just about achieving professional milestones but about building a global family—a network of surgeons and scholars who inspire, support, and uplift each other. Here, we celebrate not only our individual achievements but also the collective strength of our community.

I am deeply grateful for the privilege of serving as the Director of this remarkable platform. I extend my heartfelt thanks to Dr. Aman Goyal, Co-Director of Robotic Time Zone, and to every member of the TROGSS Executive Council, whose dedication and selflessness make initiatives like this possible. I also express my gratitude to our visionary President, Prof. Adel Abou-Mrad, and our inspiring CEO, Dr. Rodolfo J. Oviedo, for their leadership and unwavering support of our collective mission.

Robotic Time Zone is a canvas for innovation, a space where surgeons educate surgeons, new ideas take shape, and the future of robotic surgery is written. It is a testament to the power of connection—to the belief that, together, we can achieve far more than any of us could alone.

This is a space where every member of TROGSS finds a voice and a purpose. It is a room where dreams turn into action, where curiosity fuels discovery, and where the extraordinary becomes attainable. Whether you join us to share your expertise, seek mentorship, or simply connect with like-minded professionals, know that this is your space, your global family, and your platform to grow, inspire, and lead.

Together, we are building something extraordinary. This is Robotic Time Zone: a room for innovation, for unity, and for dreaming big.

And as a final note, I want to remind you that Robotic Time Zone will always be active and updated, no matter where you are or what time it is. Because in this space, it is always the Robotic Time Zone.

Let us continue to meet, innovate, and inspire across continents and time zones. Let us use this space to elevate each other, to celebrate the art and science of surgery, and to transform the future of robotic care together.

With deep appreciation and excitement for what lies ahead,

Luigi Marano, MD, PhD, MSc

Director, Robotic Time Zone

The Robotic Global Surgical Society (TROGSS)

With Gratitude, Your CEO and Friend

360… Degrees? A symbol of our exponential growth as a global society devoted to the noble mission of Advancing Robotic Surgery and Education, for Our Patients, by Our Surgeons? An image of an altruistic goal that is achieved by #empoweringinexcellence? An analogy to the very nature that gave rise to our #intercontinental community of surgeons, trainees and medical students? A graphic representation of the return to our roots in our desire to transcend boundaries, languages, and barriers that block the growth of human beings in exchange for solidarity, compassion, selflessness, and service? 

No. 360 represents the number of members and friends within the TROGSS family on the day this message was written, December 4th, 2024. It is a little over a year since TROGSS – The Robotic Global Surgical Society came to be under the leadership of a visionary President and founder who gave us a chance to dream, to transcend, to fulfill our potential by putting our talents to the service of our fellow surgeons and mentees. Today I am grateful, more than ever, for it is just the beginning, not the end of a trajectory full of challenges but with more abundant blessings and reasons to celebrate our successes, again, for Our Patients, by Our Surgeons.

1946… The year that the Baby Boom began? The point in time when the first electronic digital computer appeared in the market? The historic moment when the dreadful World War II officially came to an end? 

No. 1946 refers to how many respectable followers and subscribers have been actively checking our official LinkedIn page for updates, posts, announcements, manuscripts produced by our members, and conference news where we have taught and participated, while patiently awaiting the launch of our website today.

We have truly become a society whose essence remains pure and dignified as long as our members continue to serve one another and promote each other’s careers, education, and growth as human beings. This is the treasure of TROGSS, #thisiswhoweare: a family that stands united and promotes the democratization of #surgicaleducationforall in a system where surgeons finally educate surgeons, with industry as a respected and welcomed partner, but not as the driver of our training and growth as surgical professionals.

Gratitude is a powerful word that represents one of the most underestimated yet impactful and transcendent forces of nature. On a deeply personal note, I am infinitely grateful to God for His presence, guidance, wisdom and blessings upon my life, my family, and TROGSS. Gratitude is essential in our current era, more than ever, as we face many obstacles ranging from natural disasters, to human calamities caused by wars and division, to an uncertain future that is marked by the rise of artificial intelligence and its countless implications and possibilities. In the midst of so much fear, we stand united, we stand firm, we support each other and aim to promote the wellbeing of our patients and ourselves by staying true to our nature, a nature of humanity and compassion.

On the special occasion of the launch of our website as a professional surgical society thanks to the heroic efforts from our leaders, I wish to give special thanks to our President Prof. Adel Abou-Mrad, who entrusted me just over a year ago with the humbling yet enormous responsibility and honor to serve each of you, my dear friends and esteemed members, as your CEO. I also want to thank Prof. Luigi Marano and Dr. Aman Goyal, Director and Co-Director of #robotictimezone, respectively, which is the official means of communication and information for TROGSS, our face, our tongue, our eyes, our soul. 

I especially want to thank each of the 21 inspiring members of our #trogssexecutivecouncil who work alongside me and who have given so much of their talents and sacrifice to serve our society with love, without financial compensation for their valuable time and efforts, out of generosity and commitment to our cause. And of course, I want to especially thank Prof. Luis Osvaldo Suarez Carreon, Chair of the Membership & Engagement Committee, for his selfless support of our society by enabling us to see our website become a reality despite the challenges that arise from our nature as a non-for-profit organization that does not charge its members for the multiple benefits that it offers for free.

I could spend so many sentences and paragraphs writing as I thank each of you, my beloved friends and members, but all the space in the world wide web would not suffice to express how grateful I am to serve you and to learn from you every day as we continue to grow together. We have already accomplished so much, but #thebestisyettocome. Let us believe together that our future is bright and our present is within our grasp as our young and talented generation takes us farther than we ever imagined to reach. #thisishappening. #letsbepresent as the #trogssdiplomaticcorps.

Let us keep meeting in all continents, in so many different countries, as we attend and serve as faculty at educational events and conferences, big and small, to let everyone know as the #trogssambassadorsclub that we are here to stay. Let us promote, serve, educate, support, and show the world that we are TROGSS, that we are #oneglobalfamily that stands united and with a meaningful purpose. 

Thank you, thank you, thank you, I cannot say it enough, from the bottom of my heart and from the core of my spirit. Thank you, God! Thank you, TROGSS!

With Gratitude, 

Your CEO and Friend

Rodolfo J. Oviedo, MD, FACS, FRCS, FICS, FASMBS, DABS-FPDMBS