Robotic Surgery Training: What It Involves and What Patients Should Ask
When patients research robotic surgery, they focus almost entirely on the technology. The da Vinci system. The four arms. The magnified 3D view. What the robot can and can't do.
What they focus on less — but what matters more — is the surgeon operating it.
Robotic surgery is a platform. Like any surgical platform, its value depends almost entirely on the person using it: their technical training, their judgement about when to use it and when not to, and their ability to handle the unexpected when it arises mid-operation.
This article explains what serious training in robotic urologic cancer surgery actually looks like, and what questions are worth asking before you commit to a surgeon.
Why training pathways matter in robotic surgery
Open surgery training is highly standardised. Trainees learn under direct supervision, hands on the same instruments as their supervisor, with immediate feedback. The learning curve is visible and correctable in real time.
Robotic surgery training is different. The surgeon operates from a console, which means the supervisor — unless also at a console — cannot feel what is happening or immediately take over. This changes the dynamic of training significantly. It means that who you trained under, in what environment, and on how many cases matters more, not less.
A surgeon who has used a robotic system during general training is not the same as a surgeon who has completed a dedicated fellowship in robotic urologic oncology at a high-volume centre. The difference is not just technical — it is in the accumulated pattern recognition, the clinical judgement about case selection, and the experience of managing complexity at volume.
What a dedicated robotic fellowship involves
A dedicated robotic surgery fellowship — distinct from general urology training — typically involves spending a concentrated period at a high-volume centre under close supervision, operating on complex cases across the relevant procedures: prostatectomy, partial and radical nephrectomy, cystectomy, and upper tract surgery.
The value is not just repetition. It is operating in an environment where cases are complex enough, and volume high enough, that the unusual becomes familiar. Where the intraoperative finding that would be a crisis in a low-volume setting is something you have seen before and know how to manage.
Volume matters because robotic surgery has a recognised learning curve. For prostatectomy in particular, published data consistently shows that outcomes — continence, margins, erectile function — continue to improve with case experience well into the hundreds of cases. Training at a centre performing hundreds of robotic cases per year compresses that learning curve in a way that occasional robotic cases during general training simply cannot.
Where I trained — and why it mattered
My robotic training began during my urology registrar years in Geelong, Victoria — a public teaching hospital where I built my initial foundation in robotic technique across prostate, kidney and bladder surgery.
I then completed a dedicated one-year fellowship in robotic urologic cancer surgery at Stepping Hill Hospital, Stockport NHS Foundation Trust, in England.
Stepping Hill is a high-volume robotic urology centre in Greater Manchester, performing approximately 380 robotic urology cases per year. The department's programme covers the full range of urologic cancer operations — prostatectomy, partial and radical nephrectomy, cystectomy, and upper tract procedures — with a consultant team whose subspecialty focus is urological cancer surgery and robotic technique. The fellowship involved operating on a high volume of complex cancer cases under direct supervision, with particular emphasis on oncological precision, nerve-sparing decision-making, and the management of high-risk disease.
What that environment provides — and what is difficult to replicate elsewhere — is the accumulated experience of seeing variation. Not just the straightforward cases, but the anatomically difficult prostate, the complex renal tumour, the cystectomy after prior treatment. Patterns that only become familiar through volume.
Since returning to Australia, I have continued to build that experience across Epworth, St Vincent's Private and other major Melbourne hospitals, with a practice focused on robotic urologic cancer surgery.
What this means in practice for patients
Training pedigree matters, but it is not the only thing. Here is what I would suggest patients consider:
Training environment and case complexity. A surgeon who trained at a dedicated fellowship centre — operating on complex, high-risk cases under close supervision — has developed pattern recognition and judgement that cannot be replicated by accumulating simpler cases over time. It is worth asking not just where someone trained, but what the case mix was: locally advanced disease, difficult anatomy, and high-risk patients present problems that only become familiar through concentrated exposure to them. Robotic prostatectomy, partial nephrectomy and cystectomy are distinct procedures with distinct learning curves, and fellowship training in a programme covering all three is meaningfully different from occasional exposure to each.
Intraoperative judgement. The most important skill in robotic surgery is not technical dexterity — it is knowing when to change the plan. When to convert from robotic to open. When to extend a resection that was planned as nerve-sparing. When to stop and reassess rather than push on. This kind of judgement only comes from training in environments where the unexpected arises regularly.
Where they trained. Not all fellowships are equivalent. A fellowship at a high-volume, subspecialist centre with a dedicated robotic cancer programme is materially different from a more general robotic exposure.
Questions worth asking a robotic surgeon
These are reasonable and appropriate questions to raise before committing to surgery. A surgeon who answers them thoughtfully, with specific rather than general responses, is telling you something important.
Where did you complete your robotic surgery training, and what was the case mix and level of complexity at that centre?
What training have you had in this specific operation, and what kinds of cases have most shaped your judgement?
What proportion of your practice is urological cancer surgery versus general urology?
How do you decide between robotic and open surgery in borderline cases?
What would prompt you to change the plan intraoperatively — for example, in a nerve-sparing decision?
What is your approach when the unexpected arises during surgery?
You are not cross-examining the surgeon. You are gathering the information you need to make a considered decision about who you want to operate on you. Most surgeons who have trained seriously in this area will welcome the questions.
A note on how I approach this
My practice is weighted toward robotic urologic cancer surgery — prostate, kidney and bladder cancer — which reflects both my fellowship training and where I believe I can offer patients the most. I do not perform the full breadth of general urology that many urologists cover, and I think that focus matters for the cases I see.
When I consult with a patient about robotic surgery, I try to be honest about what the training and experience behind me actually looks like — not just that I do robotic surgery, but what that means in terms of where I trained, what I've operated on, and what my judgement is based on. That specificity is what allows patients to make a genuinely informed decision, not just a comfortable one.
If you are considering robotic surgery for a urological cancer and want to understand what my training and experience covers before deciding, contact the rooms to arrange a consultation.
For a broader overview of robotic surgery across urologic cancers, see Robotic Urologic Cancer Surgery. For information on specific procedures, see Robotic Radical Prostatectomy, Robotic Partial Nephrectomy and Robotic Radical Cystectomy.
Clinical note: This article provides general information and is not a substitute for individual medical advice. Surgical decisions should be based on personalised assessment and discussion of options.
Last reviewed: April 2026
About the author: Dr Deanne Soares is a Melbourne-based urologist with a subspecialist focus in robotic prostate, kidney and bladder cancer surgery. She completed a dedicated fellowship in robotic urologic cancer surgery at Stepping Hill Hospital, Stockport NHS Foundation Trust, a high-volume robotic urology centre in Greater Manchester.
