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BIARGS First assistant

Mandatory sign off Level I for Bottom end assistant and Level 2 for Ist bedside assistant

Simulator training (Optional)

Level 1 (Observed competencies) Core logbook if opportunity available; STI/ST2= Second assistant (Bottom end)

  • Trainee would be expected to have basic understanding of robotic surgery
  • Understand indications, complications and advantages of robotic surgery
  • Understand principles of patient selection
  • Understand principles of patient positioning, docking/undocking the robot
  • Understand importance of team working, NOTTS, situational awareness
  • Aware of other methods and resources available to improve knowledge (Online training, Simulator training, lab based training)
  • Uterine manipulation

Level 2- Able to undertake a skill under supervision (these will be main skills required for bed side first assistant surgical skills) Core logbook if opportunity available):ST3/ST4/ST5 OR First Nurse assistant = First assistant

  • Trainee would be expected to have more detailed knowledge of robotic surgery
  • Undertake online training module for robotic gynaecology surgery
  • Have competency based experience in laparoscopic basictraining
  • Trainee will be competent to perform bed side (first assistant) surgical skills (as per level 2 laparoscopic competencies)
  • Simulator training, online module
  • Communication skills, situational awareness, NOTSS

CiP 1: The practitioner is able to practice as a gynaecological Robotic Surgeon in MIS unit within a multidisciplinary team.

Trainees / Advanced surgical practitioner should have assisted with laparoscopic cases before assisting with robotic cases.
Orientation & Preparation Competence Level
Level 1 Level 2
Allied Member/Nurse ST1/ST2 Allied Member/Nurse ST3/ST4/ST5
Date Signature Date Signature
Orientation of robotic theatre
Demonstrate effective team working
Demonstrate effective communication skills within theatre tram
Demonstrate situational awareness
Demonstrate importance of Human factor
Sterile preparation of robot
Bedside assistant ( level 2)
Reflective practice
Knowledge Competence Level
Level 1 Level 2
Date Signature Date Signature
Completion of the online theoretical training package
Awareness of the ergonomics of robotic assistance
Familiar with robotic components and instrumentation
Awareness of other modalities, benefits and potential complications with robotic surgery
Knowledge of different docking positions and the indications
Understands reasons for arm clashing and methods of correction
Knowledge of the potential complications of electro diathermy
knowledge of principles of laparoscopy and robotic surgery
Situational awareness
Communication skills

CiP 2: The practitionar provides high quality perioperative and Robotic assisted gynaecological surgical care within a MIS unit.

Robotic Assistant competence
Orientation & Preparation Competence Level
Level 1 Level 2
Nurse ST1/ST2 Nurse ST3/ST4/ST5
Date Signature Date Signature
Knowledge of the operative room setup of the robotic system
Aware of principles of the robotic system
Be able to drape the Robot
Be able to respond to system errors
Able to drive the robot
Knowledge of how to position patient for robotic surgery
Undertake vaginal preparation for a robotic procedure
Able to insert McCartney tube in vagina if required
AAble to insert uterine manipulator if required
Be able to undertake vaginal preparation & insert a rectal probe if required
Understand and demonstrate use of different methods of maintaining pneumoperitoneum
Demonstrate understanding port placement
Be able to dock the robotic system
Understand different docking positions and able to dock the robot
Be able to maintain a clear image by cleaning/changing the camera
Be able to insert, change and remove robotic instruments
Be able to understand reason for clashing and adjust the arm positions
Have understanding of the appropriate use of assistant port
Demonstrates of use of suction and maintaining clear operative field
Able to introduce and present loaded needle
Able to cut the suture with laparoscopic scissors
Safe retrieval of needle
Demonstrate understanding of communication with scrub team and needle/swab count
Demonstrate introduction and retrieval of specimen bag/ swabs
Undocking and port closure (3 cases – level 4)
Be able to close incisions and port sites closure
Be able to perform an emergency undocking procedure
Demonstrate understanding of specimen handling and histology/cytology requests
Demonstrate effective communication with anaesthetic , theatre team and console surgeon
Demonstrate skills of communication with recovery and ward staff