Video-Assisted Thoracoscopic Surgery: A Model Global Learning Framework

Background Video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach for the treatment of lung cancer and other lung diseases. Although VATS is associated with better outcomes compared with open surgery, the extensive skill and knowledge requirements may prolong the learning curve and limit adoption. Objective The objective of this work was to develop a training model that optimizes skill acquisition while shortening the learning curve of novel surgical procedures, with a specific application to VATS training. Methods A seven-step training method was developed. A board of thoracic surgeons was then surveyed by a Delphi process to validate the method within the context of a VATS curriculum. Results The Delphi consensus established the following: 1) there is a need for a standardized, stepwise training approach for VATS lobectomy; 2) the seven-step method can be locally adapted and applied to VATS training and maximizes the chances of success for both the individual and the institution; 3) the framework is universal and can be adapted for other novel devices and procedures; 4) the model covers the elements needed to make it safe and provide good outcomes for patients; and 5) the training method has the necessary requirements to be established as standard practice. Conclusion This paper presents the educational components that are needed to form a standardized curriculum for VATS, as agreed by a panel of established thoracic surgeons through a Delphi process. The training framework considers both individual and team-specific skills along the learning curve to optimize outcomes for patients.