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Robot assisted versus laparoscopic suturing learning curve in a simulated setting.

Erik Leijte1, Ivo de Blaauw2, Frans Van Workum3

  • 1Department of Pediatric Surgery, Radboud University Medical Centre - Amalia Children's Hospital, Geert Grooteplein 10 Route 618, 6500HB, Nijmegen, The Netherlands. Erik.leijte@radboudumc.nl.

Surgical Endoscopy
|November 23, 2019
PubMed
Summary

Robot-assisted surgery significantly shortens the learning curve for minimally invasive suturing compared to conventional laparoscopy. While robotic procedures are faster, laparoscopic suturing demonstrates rapid improvement and excellent end results.

Keywords:
Laparoscopy trainingLearning curveRobotics trainingSimulation

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Simulation
  • Robotic Surgery

Background:

  • Robot-assisted surgery shows promise for complex procedures like minimally invasive suturing.
  • Conventional laparoscopy presents challenges in technically demanding surgical tasks.

Purpose of the Study:

  • To compare the learning curves of laparoscopic versus robot-assisted suturing.
  • To identify differences in skill acquisition for novice surgeons in minimally invasive suturing.

Main Methods:

  • Novice participants practiced suturing tasks on virtual reality simulators (laparoscopic and robotic).
  • Tasks included intracorporeal suturing, tilted plane needle transfer, and anastomosis needle transfer.
  • Learning curves were analyzed based on time, movement, and safety parameters over multiple repetitions.

Main Results:

  • Robot-assisted suturing demonstrated significantly shorter task completion times compared to laparoscopy.
  • Laparoscopic suturing showed a higher percentage of adequate surgical knots throughout the learning process.
  • Robotic assistance led to fewer instances of instruments being out of view.

Conclusions:

  • Robotic assistance accelerates the learning curve for minimally invasive suturing in terms of time.
  • Laparoscopic suturing, despite a potentially longer time curve, achieves good outcomes with rapid improvement.
  • Both approaches offer distinct advantages in surgical skill acquisition for suturing.