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It seems there may be some documentation missing regarding the credentialing process. What's included shows "Step I" which concludes with stating the surgeon must operate under continuous proctoring. It then skips to a description of the requirements for proctors. What appears to be omitted are the steps that would lead to a surgeon operating independently (without which no surgeon would ever qualify as a proctor). Presumably there is a missing Step II or even more.

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Aug 8, 2022·edited Aug 8, 2022

Credentialing for robotic surgery is extremely lax and really just a formality. It is treated as a tool that the surgeon ultimately takes responsibility for. The "8 hours" are typically an online certification course with the robot manufacturer. It is assumed however that you are not using a tool unless you are trained in it, which almost all urologists heavily use the robot in training now. My current hospital credentialing requested prior robotic case numbers in addition to the 8 hour course certificate, but I don't know that they had a minimum case load.

Unclear what this urologist's robotic surgery training was back in 2016. I agree with your review about the generic statement from the expert witness saying this was a bad outcome. I have seen very talented urologists perform successful robotic surgeries on patients who have complex abdominal surgical histories, so that is not a contraindication alone.

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