Are basic robotic surgical skills transferable from the simulator to the operating room? A randomized, prospective, educational study

Abstract

Introduction: We aimed to assess the transferability of basic robotic skills from the simulator to the operating room while performing robotic-assisted radical prostatectomy (RARP) prostatectomy).
 Methods: Fourteen urology residents were randomized to two groups: group A was required to practice three sessions (nine tasks each) on the simulator, whereas group B was required to practice (same nine tasks) until they reached competency. Both groups were recorded while practicing on the da Vinci Surgical Skills Simulator (da Vinci Simulator). Both groups were then recorded while performing bladder mobilization during RARP. Senior residents from both groups were also recorded while performing urethro-vesical anastomosis during RARP. Recordings were assessed blindly using the validated GEARS tool by C-SATS. Spearman’s correlation coefficient (rho) was used to assess correlation between GEARS scores from practice sessions on the da Vinci Simulator and the GEARS scores from bladder mobilization and urethro-vesical anastomosis during RARP.
 Results: There was no difference in total GEARS scores between the two groups in the operating room. Total GEARS scores for “ring and rail 2” and “suture sponge” tasks correlated with the total GEARS scores during urethro-vesical anastomosis (rho=0.86, p=0.007; rho=0.90, p=0.002, respectively). GEARS’ efficiency component during “energy and dissection” task on the da Vinci Simulator correlated with GEARS’ efficiency component during bladder mobilization (rho=0.62, p=0.03). GEARS’ force sensitivity component during “ring and rail 2” and “dots and needles” tasks on the da Vinci Simulator correlated with GEARS’ force sensitivity component during bladder mobilization (rho=0.58, p=0.047; rho =0.65, p=0.02, respectively).
 Conclusions: Objective assessments of urology residents on the da Vinci Surgical Skills Simulator tasks ring and rail 2 and suture sponge correlated with their objective assessments of bladder mobilization and urethro-vesical anastomosis. Therefore, basic robotic skills could be transferred from the simulator to the operating room.

Standard Setting in Simulation-based Training of Surgical Procedures

“…A total of 13 studies (8.0%) used the mean/median score but amended this by subtracting 1 or 2 standard deviations. 52,[60][61][62][63][64][65][66][67][68][69][70][71] The authors typically argue that the aim of SBT is not to reach the competence level of experienced surgeons but to increase the competency level when performing the first clinically, patient-related procedures and minimize the risk of errors.…”

Construction and Evaluation of a Virtual Reality Laparoscopic Surgery Collaborative Training Platform: Taking Laparoscopic Cholecystectomy as an Example

“…[12] Indeed, the skills gained through the surgical simulator can be translated into real-world surgical level improvement. [20] In our case, the C-STRD students' performance in the exploration mode did improve after the training. The beauty of the exploration mode lies in the opportunity to fail at any given time without consequences, which develops their independent learning skills.…”

Robotic Surgery: Rediscovering Human Anatomy

“…The use of VR simulation in surgical training has already been shown to improve knowledge, self-confidence, and surgical skill [ 17 , 18 , 19 ]. In addition, there is already preliminary evidence indicating promising clinical applications of VR training for procedures such as cholecystectomy and knee arthroscopy [ 20 , 21 , 22 ]. The ability for a good training performance to translate to more successful clinical outcomes is what makes education through simulation a viable educational tool.…”