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Robotic surgery training takes on 100th surgical team

U.S. Air Force Lt. Col. Josh Tyler, 81st Surgical Operations Squadron Institute for Defense Robotic Surgery Education director, and Maj. Scott Thallemer, 81st MSGS InDORSE robot coordinator, pose for a photo in the Clinical Research Lab on Keesler Air Force Base, Mississippi, June 27, 2019. InDORSE is a program created by Tyler and Thallemer to provide surgeons with training on the DaVinci Xi surgical robot. Keesler AFB was the first hospital to have the DaVinci Xi in the Air Force. (U.S. Air Force photo by Airman 1st Class Kimberly L. Mueller)

U.S. Air Force Lt. Col. Josh Tyler, 81st Surgical Operations Squadron Institute for Defense Robotic Surgery Education director, and Maj. Scott Thallemer, 81st MSGS InDORSE robot coordinator, pose for a photo in the Clinical Research Lab on Keesler Air Force Base, Mississippi, June 27, 2019. InDORSE is a program created by Tyler and Thallemer to provide surgeons with training on the DaVinci Xi surgical robot. Keesler AFB was the first hospital to have the DaVinci Xi in the Air Force. (U.S. Air Force photo by Airman 1st Class Kimberly L. Mueller)

KEESLER AIR FORCE BASE, Miss. --

The Institute for Defense Robotic Surgical Education program celebrated a significant milestone, training the 100th team on robotic surgery at Keesler Air Force Base, Mississippi, on July 23.

This milestone is significant for Keesler’s InDORSE program, showing how far the curriculum has come since the program first stood up in March 2017 with just one robot. Now, InDORSE has acquired a second robot, allowing them to train more military surgical teams across the Department of Defense (DoD), as well as Department of Veteran’s Affairs (VA).

The program continues to grow with plans to double its training capacity starting in July, and will also offer additional course curriculum, including more advanced courses.  Currently, the federal government owns over 100 surgical robots between the DoD and VA, representing an investment of over $200 million.

Lt. Col. Josh Tyler, 81st Surgical Operations Squadron InDORSE director, had the vision for the robotic surgery training program, along with assistance from Maj. Scott Thallemer, 81st MSGS InDORSE robot coordinator.

“My idea was to create this site so we could train our military surgeons in-house,” said Tyler. “The site was built in collaboration with Intuitive, the DaVinci Xi surgical robot manufacturer. They provide the trainer and teach their curriculum and that comes at no cost to the federal government.  In the current fiscal environment, it is important for us to find sustainable models for surgical education.”

According to Tyler, who recently returned from deployment supporting Operation Inherent Resolve, personnel turnover and military operational tempo are the main obstacles to successful robotic implementation in federal sector healthcare.  With the InDoRSE setup, these obstacles are directly addressed.  There is also tremendous cost savings with the in-house training paradigm.  InDoRSE training costs $3,500 less than industry sites, and with the number of personnel trained the educational savings totals over $1 million.

The in-house program not only includes affordable training, but also trains nurses and technicians, in addition to surgeons, which makes Keesler AFB’s InDORSE training program different from traditional industry sites. 

“Good surgery has always been about being a team in the operating room,” said Tyler. “This program really lets us train the team, not just the individual, and I think that’s what is so important about this site.”

Tyler started out with four different coordinators in hopes to get his program started, but the one who matched his passion was the fifth, Thallemer.

“I went up to Dr. Tyler and said, ‘They said I’m going to be your new coordinator.’ He replied, ‘Oh, great,’ and kept walking,” said Thallemer. “I’ve had a DaVinci procedure before so I was very interested in the program. I had to chase Dr. Tyler down the hallway a little bit and say, ‘No, really, I can implement this. We can do this.’” 

On recalling this story, Tyler laughs and notes, “Without Maj. Thallemer, we wouldn’t be where we are.  His hard work has been invaluable”.

Through Tyler and Thallemer’s hard work, the program continues to grow and they intend to push it farther, aiming to expand the program and eventually quadruple their capacity for training.  With one robot, they have now trained over 100 surgeons and an additional 200 nurses and OR technicians, for a total of over 300 personnel.  This includes 37 different facilities spanning Army, Navy, Air Force, and Veteran’s Affairs hospitals and surgeons from 10 different specialties.  Those surgeons have returned home and done almost 1,500 robotic surgical procedures.

 “This site is changing the face of federal sector surgery, particularly with patient outcomes,” said Tyler.  “We are teaching these teams how to leverage the latest technology to produce the best outcomes for our patients, and with better outcomes come lower costs.  We focus on creating a culture of efficiency and patient safety.  Additionally, robotics will improve both recruitment and retention, and those are equally important as they improve readiness.”

“This is my passion,” said Tyler. “I love robotics, and this achievement validates the vision I had so long ago, and all the work Thallemer and I have put into this. It’s very exciting to help surgeons and other hospitals have access to the technology to have the best outcomes for our patients.”