Objective
To develop and establish effectiveness of simulation-based robotic curriculum - fundamental
skills of robotic surgery (FSRS).
Methods
FSRS curriculum was developed and incorporated into a virtual reality simulator, Robotic
Surgical Simulator (RoSS). Fifty-three participants were randomized into an experimental
group (EG) or control group (CG). The EG was asked to complete the FSRS and 1 final
test on the da Vinci Surgical System (dVSS). The dVSS test consisted of 3 tasks: ball
placement, suture pass, and fourth arm manipulation. The CG was directly tested on
the dVSS then offered the chance to complete the FSRS and re-tested on the dVSS as
a crossover (CO) group.
Results
Sixty-five percent of participants had never formally trained using laparoscopic surgery.
Ball placement: the EG demonstrated shorter time (142 vs 164 seconds, P = .134) and more precise (1.5 vs 2.5 drops, P = .014). The CO took less time (P <.001) with greater precision (P <.001). Instruments were rarely lost from the field. Suture pass: the EG demonstrated
better camera utilization (4.3 vs 3.0, P = .078). Less instrument loss occurred (0.5 vs 1.1, P = .026). Proper camera usage significantly improved (P = .009). Fourth arm manipulation: the EG took less time (132 vs 157 seconds, P = .302). Meanwhile, loss of instruments was less frequent (0.2 vs 0.8, P = .076). Precision in the CO improved significantly (P = .042) and camera control and safe instrument manipulation showed improvement (1.5
vs 3.5, 0.2 vs 0.9, respectively).
Conclusion
FSRS curriculum is a valid, feasible, and structured curriculum that demonstrates
its effectiveness by significant improvements in basic robotic surgery skills.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to UrologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre.Qual Saf Health Care. 2009; 18: 109-115
- Adverse events in British hospitals: preliminary retrospective record review.BMJ. 2001; 322: 517-519
- Errors in medicine.Clin Chim Acta. 2009; 404: 2-5
- Current status of robot-assisted surgery in urology: a multi-national survey of 297 urologic surgeons.Can J Urol. 2009; 16 ([discussion: 4741]): 4736-4741
- Practice, rehearsal, and performance: an approach for simulation-based surgical and procedure training.JAMA. 2009; 302: 1336-1338
- Impact of robotics and laparoscopy on surgical skills: a comparative study.J Am Coll Surg. 2007; 204: 96-101
- Can image-based virtual reality help teach anatomy?.J Endourol. 2010; 24: 629-634
- The Delphi method: techniques and applications. Reading.Addison-Wesley Publishing Co., Advanced Book Program, Massachusetts.1975
- Face validation of a novel robotic surgical simulator.Urology. 2010; 76: 357-360
- Content validation of a novel robotic surgical simulator.BJU Int. 2011; 107: 1130-1135
- Current status of validation for robotic surgery simulators - a systematic review.BJU Int. 2012; ([Epub ahead of print])
- Validation, correlation, and comparison of the da Vinci Trainer(™) and the da Vinci Surgical Skills Simulator(™) using the Mimic(™) software for urologic robotic surgical education.J Endourol. 2012; 26: 1629-1634
- Face, content, and construct validation of the Da Vinci Skills Simulator.Urology. 2012; 79: 1068-1072
- Validation study of a virtual reality robotic simulator–role as an assessment tool?.J Urol. 2012; 187: 998-1002
- Content and face validity of a comprehensive robotic skills training program for general surgery, urology, and gynecology.Am J Surg. 2012; 203: 535-539
- Validating the use of the Mimic dV-trainer for robotic surgery skill acquisition among urology residents.Urology. 2011; 78: 1326-1330
- Concurrent and predictive validation of a novel robotic surgery simulator: a prospective, randomized study.J Urol. 2012; 187: 630-637
- Editorial comment.J Urol. 2011; 186: 1024
- How do we improve techniques in robotic surgery?.J Urol. 2011; 185: 1186-1187
Article info
Publication history
Published online: February 27, 2013
Accepted:
December 26,
2012
Received:
November 16,
2012
Footnotes
Financial Disclosure: Khurshid Ahad Guru, Thenkurussi Kesavadas and James O. Peabody, share holders of Simulated Surgical Systems LLC. James O. Peabody, Intuitive Surgicals speaker bureau.
Funding Support: This work was funded by the John R. Oishei Foundation and the Roswell Park Alliance Foundation.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
