Expert consensus on robotic colorectal surgery proctoring in the UK.

Abstract

The adoption of robotic-assisted surgery (RAS) in colorectal practice is accelerating, supported by growing evidence of clinical benefit. Robotic proctors play a critical role in ensuring safe dissemination by guiding and supporting new users. However, national standards outlining their responsibilities, training and governance remain undefined. All UK-based colorectal robotic proctors within the Association of Coloproctology of Great Britain and Ireland (ACPGBI) were invited to participate in a consensus process structured around eight predefined domains. These were informed by a prior scoping meeting. Participants received a summary report and had the opportunity to propose additional themes. A modified nominal group technique was used to generate and vote on statements. Final statements were circulated for further input post-meeting. Twelve of twenty invited proctors participated. A total of 32 statements were generated; 30 reached consensus and 21 were unanimously supported. Key recommendations include: (1) Robotic proctorship in the UK should encompass proctoring, preceptoring, coaching and mentoring tailored to individual surgeon needs. (2) Proctors should complete a robotic-specific 'Train the Trainers' course or equivalent. (3) Proctors must ensure the proctee can safely operate the system whilst maintaining patient safety and delivering structured feedback. (4) Industry should support communication, theatre team training and structured feedback mechanisms. (5) A distinction should be made between first- and second-generation proctors to support safe innovation in new robotic platforms. This expert consensus provides one of the first structured frameworks for robotic proctoring in colorectal surgery, aiming to improve training consistency, professional standards and patient safety.