Objective assessment of robotic suturing skills with a new computerized system: A step forward in the training of robotic surgeons

Abstract

Introduction The purpose of this study was to assess robot‐assisted suturing skills on a laparoscopic intestinal anastomosis model by using a novel computerized objective assessment system. Methods This study compared the suturing skills of 13 surgically naïve participants on an artificial intestinal anastomosis model that mimics real tissue. Each examinee sutured using da Vinci robot assistance under 2‐D and 3‐D visualization and with conventional laparoscopy (CL). Pressure‐measuring and image‐processing devices were employed to quantitatively evaluate suturing skills. Five unique criteria were used to evaluate the skills of participants. Results Suturing under 3‐D visualization (P < 0.01) and with CL (P < 0.05) were significantly faster than under 2‐D visualization. Sutures placed under 3‐D (P < 0.05) and 2‐D (P < 0.01) visualization had significantly better suture tension than those placed with CL, which did not meet acceptable values for suture tension. Sutures placed with CL had significantly better air pressure leakage than those placed under 2‐D visualization (P < 0.05), which did not meet acceptable values for air pressure leakage and wound opening area. One participants failed to achieve full‐thickness sutures with 2‐D, two participants with CL, and one participant with 3‐D. Conclusion Using 3‐D vision is necessary for complex maneuvering during robot‐assisted minimally invasive surgery. Our quantitative assessment system is useful for evaluating the skill acquisition of surgeon‐trainees undergoing robotic surgery training.

A first case of ileocecal resection using a Senhance Surgical System in Japan

“…In addition, the operating handle of the apparatus has tactile feedback, which will be of help during suturing and cutting. It has been reported that 3D vision was significantly faster than the two-dimensional (2D) vision available during da Vinci-assisted surgery [10], and 3D vision may help to perform the surgical operation more easily. The surgeon takes a seat where an adjustment is possible for perfect positioning and chooses an erect posture.…”

Evaluation of the hinotori TM Surgical Robot System for accurate suturing in small cavities

“…This is an objective and quantitative assessment system that examines the performance of suture ligature methods in an arti cial intestinal anastomosis model that utilizes four layers: mucosal, submucosal, muscle, and serosal. These intestinal suture sheets simulate human tissue, enabling quantitative assessments of performance time, air pressure leak volume, suture tension, number of fullthickness sutures, and wound opening area [21][22][23]. Each parameter received a score of up to 5 points, with a maximum total score of 25 points.…”