Objective performance indicators provide a novel, quantitative method to evaluate surgeon proficiency in robotic lobectomy training.

Objective: Current evaluation of robotic surgeon proficiency relies on subjective assessment. The robotic platform collects highly granular kinematic data on surgeon activity, known as objective performance indicators (OPIs). We sought to compare surgeon proficiency during lobectomies across training levels using OPIs. Methods: Under institutional review board approval, we analyzed robotic lobectomies between November 2022 and February 2023 performed by 2 expert robotic thoracic surgeons (>200 robotic lobectomies) and their trainees using OPI recorders. A professional annotator segmented each case into standardized steps, and an operating surgeon (trainee or attending) was assigned to that step on the basis of the active console. Kinematic data were compared between surgeon groups. A subgroup analysis was performed dividing the trainee group into junior (postgraduate year 3-5) and senior residents (postgraduate year 6-8). Results: In total, 26 lobectomies with 410 discrete tasks performed by attending surgeons and 344 by trainees were included. In the attending group, there were significantly greater rates of camera clutching per minute compared with trainees (2.94 vs 2.52, respectively; Conclusions: There are significant differences in objective performance indicators between expert and beginner robotic surgeons. These results demonstrate the feasibility of incorporating kinematic performance data into thoracic surgeon assessment in a clinical setting.