Surgeon Certification as "Provisional Console Surgeon"
(Established August 2022)

If a person has extensive experience as a first assistant at a facility already performing robot-assisted cardiac surgery, they are judged to understand the characteristics of robot-assisted cardiac surgery. Considering that currently only valvuloplasty is approved as an insurance-covered procedure for robot-assisted surgery, it is believed that robot-assisted cardiac surgery can be performed with a certain level of mitral valvuloplasty experience. The following certification standards for "provisional console surgeon" are hereby established.

Provisional Console Surgeon Standards

1. Must be a board-certified cardiovascular surgeon.
2. Must be proficient in robot-assisted cardiac surgery.
3. Must have a certain level of experience in mitral valvuloplasty.

Provisional Console Surgeon Standards - Required Documents

1. Surgical records proving experience as a first assistant in 30 robot-assisted cardiac surgery cases
   * Does not apply if participating as a bedside second assistant
   * First assistant experience should preferably be at the same facility
2. Surgical case list proving performance as primary surgeon in at least 15 mitral valvuloplasty procedures (regardless of approach method)
   Provisional Console Surgeon Application Surgery List [Excel file 11KB]
   * Valvuloplasty experience from other facilities may be combined
   * Cases where the applicant performed only the valvuloplasty portion of a combined surgery are not recognized.
3. Surgical records, discharge summaries, and echocardiography findings at discharge for all cases
   * Patient names must be anonymized by redaction or similar means.
   Assign the same sequential number to surgical records, discharge summaries, and echocardiography findings so they can be cross-referenced with the summary.

If the above standards are met, application for provisional console surgeon status to the Council becomes possible.
If, after review of surgical experience, it is determined that robot-assisted surgery cannot be performed safely, the Council may suspend the application, and the surgeon may reapply after gaining the specified additional experience.

If deemed qualified as a provisional console surgeon, undergo the following training for console surgeons.

• Online Training (for surgeons)
• On-Site Training (for surgeons)
• Off-Site Training (for surgeons)

Cadaver training and case observation are not required for provisional console surgeon certification.
After confirming completion of each of the above training programs, the Council will certify as a provisional console surgeon.
(See here for a list of required training)

When a Provisional Console Surgeon Performs Robot-Assisted Surgery

When a provisional console surgeon performs surgery, the initial 3 cases require proctor guidance.
The proctor submits a proctor report to the Council.
Thereafter, perform at least 7 additional cases under the guidance of an existing console surgeon at the facility (regardless of proctor qualification), performing at least 10 robot-assisted cardiac surgeries in total. The above 10 cases must include at least 5 MVP procedures.
Note: The instructor must be present in the operating room to provide guidance on robot operation

The instructor creates a report for each case (created and hand-signed by the instructor) and sends it to the provisional console surgeon.
The provisional console surgeon submits to the Council a list of the 10 performed surgeries and guidance reports for all cases, and the Council deliberates on the eligibility as an independent "console surgeon." Additional guidance may be required as necessary.
If serious complications occur during the process, the instructor must report to the Council each time.