Validation of a Novel Virtual Reality Training Curriculum for Robotic Cardiac Surgery a Randomized Trial

Valdis, Matthew; Chu, Michael; Schlachta, Christopher M.; Kiaii, Bob

doi:10.1097/imi.0000000000000222

Cited by 31 publications

(27 citation statements)

References 18 publications

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“…In robotic surgery, the value of coaching to get through the learning phase as quickly as possible has been underappreciated and largely overlooked. Computer simulation and cadaver dissection have been proposed as useful for team practice but these only teach the basics (Valdis 2015). The fidelity of available models is not adequate to develop or test the types of skills that would influence patient outcome.…”

Section: Introductionmentioning

confidence: 99%

Anesthetic Considerations in Robotic Cardiac Anesthesia

Schachter¹,

Poston²,

Kaye³

et al. 2017

Perioperative Management in Robotic Surgery

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Section: Introductionmentioning

confidence: 99%

Anesthetic Considerations in Robotic Cardiac Anesthesia

Schachter¹,

Poston²,

Kaye³

et al. 2017

Perioperative Management in Robotic Surgery

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“…The virtual reality curriculum that we created for this experiment was designed in a similar fashion to previous literature [8]. For this we had our expert robotic surgeons identify the basic robotic skills that were necessary for robotic cardiac surgery.…”

Section: Short Communicationmentioning

confidence: 99%

“…An extensive amount of time was spent working with these exercises in order to determine which were the easiest to understand, focused most directly on the skill we were interested in developing and which was the most users friendly. From this we constructed a 9-exercise curriculum that began with simple robotic skills such as camera clutching and movements, and slowly progressed the user though more complex tasks such and endowrist manipulation, fourth arm control and eventually to advance needle handling and intracorporeal knot-tying [8]. Completion of this program to the level of competency set by our experts proved to be a lengthy and arduous process for our trainees.…”

Section: Short Communicationmentioning

confidence: 99%

“…Each of these simulation platforms was carefully designed with the input from multiple expert robotic surgeons in order to focus on the most important and universal robotic skills necessary to operate the robot successfully. The actual protocols can be found published elsewhere [3,8]. Once the training in each stream was completed, and trainees were able to meet the levels of proficiency set by our expert surgeons, they were brought back to repeat the initial assessment which again was recorded, deidentified and scored to look for improvements with training and to compare performances between the different groups.…”

Section: Short Communicationmentioning

confidence: 99%

“…This largely prevents the development of the bad habits, that were mentioned earlier, and forces the trainee to complete the tasks in the correct manner. Progression with our curriculum creates a stable foundation of basic skills that slowly build on one another to leave the individual a competent technician of the surgical robot at its completion [8].…”

Section: Short Communicationmentioning

confidence: 99%

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The Evolution of Robotic Surgical Training: A Short Communication on the Evaluation of Robotic Cardiac Surgery Simulation Training: A Randomized Controlled Trial

Valdis¹

2016

J Clin Exp Cardiolog

Self Cite

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Robotic cardiac surgery possesses great potential for both patient and societal benefits in regards to postoperative pain, infection rates, cosmesis, and earlier return to normal activity [1,2]. Despite these proven benefits, robotic cardiac surgery is offered at a relatively small number of institutions and has largely failed to be adopted by the majority of cardiac surgeons. There are several reasons explaining the reluctance to accept this new technology in cardiac surgery, including; aging surgeon demographics, high upfront and operating costs, scarcity of randomized trials, etc. Each of these factors plays an intricate and dynamic role in altering institution and surgeon perceptions and willingness to adapt to patient demands for minimally invasive techniques. Similar to the adoption of laparoscopic and thoracoscopic techniques in other specialties, robotics requires the acquisition of an entirely new skill set from traditional "open" operations. This learning curve unfortunately can be a difficult and anxiety provoking period for the institution, patient and surgeon, and can be fraught with higher rates of complications and adverse events. This is even more significant in robotics, as the high upfront investment of significant resources and increased operating costs, create little room for anything but exceptional clinical results and patient outcomes, as patients and institutions demand a return on their investments [3]. This fact may be, by far, the greatest barrier as to why robotics has failed to become more mainstream in cardiac surgery. Truly subspecialized centers of excellence in robotics are few and far between and consist mainly of a small number of early adopters of the technology. These centers have made the commitment to invest huge resources to get their programs off the ground, and then recruit large numbers of patients to provide a steady caseload in order to maintain and advance their surgical skills and abilities, and make a robotic surgery program financially viable at their center. At most institutions this is not possible. The reluctance of many surgeons and institutions to accept robotics is not solely due to the high upfront and operating costs (as all cardiac surgery operating rooms are expensive to initiate and keep running), but rather because of the steep learning curve that is associated with these non-traditional techniques, and the difficulty in achieving optimal patient outcomes during this process. In an age where coronary bypass and mitral valve surgery carries an operative mortality rate of ~2-3% (especially when patients are stratified for the low-risk individuals typically selected for robotic surgery), proving robotics to be a superior alternative to traditional sternotomy is a difficult task. No institution is going to invest millions of dollars up front and allow for early graft failures, high conversion rates, longer operating and cardiopulmonary bypass times and the potential for increased morbidity, mortality and inferior patient outcomes. No insurance company is g...

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Robotic CABG via Minithoracotomy: Advantages, Challenges, and Pitfalls

Poston¹

2021

Robotic Surgery

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Validation of a Novel Virtual Reality Training Curriculum for Robotic Cardiac Surgery a Randomized Trial

Cited by 31 publications

References 18 publications

Anesthetic Considerations in Robotic Cardiac Anesthesia

Anesthetic Considerations in Robotic Cardiac Anesthesia

The Evolution of Robotic Surgical Training: A Short Communication on the Evaluation of Robotic Cardiac Surgery Simulation Training: A Randomized Controlled Trial

Robotic CABG via Minithoracotomy: Advantages, Challenges, and Pitfalls

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