Feasibility study

1. To evaluate the feasibility of PBP training for nerve-sparing RARP on the Hugo Ras system
2. To assess time to proficiency for participants with varying experience
3. To identify challenges in PBP RARP training through observed errors and feedback

As robotic surgery advances, the emergence of new platforms such as the Hugo™ Robotic-Assisted Surgery System calls for robust training frameworks. Proficiency-Based Progression (PBP) provides a structured method to ensure skill acquisition through clearly defined, measurable benchmarks. This study evaluates the feasibility of implementing a PBP curriculum to train urologists in nerve-sparing robot-assisted radical prostatectomy (RARP) using the Hugo™ system.

Twelve urologists and urology residents will participate, divided into three groups based on experience:

Robotic-naïve Intermediate (Da Vinci experience only) Expert RARP surgeons (Da Vinci experience without prior Hugo exposure)

The PBP training pathway comprises:

Cognitive modules (e-learning with MCQ validation) Psychomotor skills training (device familiarization and basic surgical skills) Procedural training (nerve-sparing RARP on porcine models)

Performance will be evaluated both in real time and via blinded video review.

Primary endpoints include the time to reach proficiency in basic skills and procedural steps, analyzed by prior experience. Secondary endpoints encompass error profiles, participant and instructor feedback, and the feasibility of standardizing proficiency metrics.

Inclusion Criteria:

• We'll only include urologist or urology residents to ensure that they have all the same interest and area of expertise

Exclusion Criteria:

Prior experience with the Hugo robotic system. Participants unable to attend all training days. Non-urology residents or consultants

urology residents and urologists