Robotic Surgery

Fundamentals of Robotic Surgery (FRS)

A New Chapter for the Fundamentals of Robotic Surgery (FRS)

In July 2025, ownership of FRS was transferred from ISE to SAGES. Going forward, SAGES will oversee all updates to FRS, with ISE actively collaborating throughout the development process.

FRS - A Historical Perspective

FRS is a joint education and training program funded through a Department of Defense grant and an unrestricted educational grant from Intuitive Surgical. FRS is a multi-specialty, proficiency-based curriculum of basic technical skills to train and assess surgeons to safely and efficiently perform robotic-assisted surgery. It was developed by over 80 national/international robotic surgery experts, behavioral psychologists, medical educators, statisticians, and psychometricians. The clinical robotic surgery subject matter experts represented all the major surgical specialties in the United States that currently perform robotic-assisted surgical procedures, the Department of Defense, and the Veterans Administration (VA).

There were four consensus conferences conducted prior to developing the FRS curriculum.

01. Outcome Measures

02. Curriculum Planning

03. Curriculum Development

04. Validation Study Design

The resulting curriculum consisted of 4 modules.

  • Module 1

    Introduction to Surgical Robotic Systems

  • Module 2

    Didactic Instructions for Robotic Surgery

  • Module 3

    Psychomotor Skills Curriculum

  • Module 4

    Team Training & Communication Skills

ISE then managed the international proficiency-based progression training program validation study that included 12 major American College of Surgeons’ Accredited Education Institute (ACS-AEI) centers. The results were published in the Annals of Surgery in August 2020.

ISE also developed a new FRS Dome to train and assess the proficiency of the psychomotor robotic skills of surgeons. A proficiency-based progression (PBP) model is used where trainees perform tasks that can be assessed by objective measures and the avoidance of errors. Trainees can repeat a task as many times as necessary until they consistently achieve an expert benchmark. Review FRS Dome Usage Instructions.