Fundamental Skills of Robotic Surgery: A Multi-institutional Randomized Controlled Trial for Validation of a Simulation-based Curriculum - 27/03/13
Reprint requests: Khurshid Ahad Guru, M.D., Robert P Huben Professor of Urologic Oncology, Department of Urology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263.Abstract |
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.
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| 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. |
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| Funding Support: This work was funded by the John R. Oishei Foundation and the Roswell Park Alliance Foundation. |
Vol 81 - N° 4
P. 767-774 - avril 2013 Retour au numéro
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