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Published on: May 20, 2018
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Are basic robotic surgical skills transferable from the simulator to the operating room? A randomized, prospective,
Ahmad Almarzouq1, Jason Hu1, Yasser A Noureldin1,2
1Division of Urology, McGill University Health Centre, Montreal, QC, Canada.
Summary
Basic robotic skills learned on a simulator, specifically tasks like "ring and rail 2" and "suture sponge," correlate with performance in robotic-assisted radical prostatectomy (RARP). This suggests effective transfer of surgical skills from simulation to the operating room (OR).
Area of Science:
- Surgical Education
- Robotic Surgery
- Urology
Background:
- Assessing the transferability of basic robotic skills from simulation to the operating room (OR) is crucial for effective surgical training.
- Robotic-assisted radical prostatectomy (RARP) is a complex procedure where simulator training may enhance resident proficiency.
Purpose of the Study:
- To evaluate the correlation between performance on da Vinci Surgical Skills Simulator tasks and actual surgical performance during RARP.
- To determine if basic robotic skills acquired in a simulated environment are transferable to the operating room.
Main Methods:
- Fourteen urology residents were randomized into two groups: one practiced simulator tasks until competency, the other completed a set number of sessions.
- Performance on simulator tasks and during RARP procedures (bladder mobilization, urethro-vesical anastomosis) was recorded and blindly assessed using the Global Evaluative Assessment of Robotic Skills (GEARS) tool.
- Spearman's correlation coefficient was used to analyze the relationship between simulator GEARS scores and OR GEARS scores.
Main Results:
- No significant difference in overall GEARS scores was observed between the groups in the OR.
- Specific simulator tasks, "ring and rail 2" and "suture sponge," showed significant correlation with GEARS scores during urethro-vesical anastomosis (rho=0.86, p=0.007; rho=0.90, p=0.002).
- The efficiency component of "energy and dissection" on the simulator correlated with bladder mobilization efficiency (rho=0.62, p=0.03), and force sensitivity in "ring and rail 2" and "dots and needles" correlated with bladder mobilization force sensitivity (rho=0.58, p=0.047; rho=0.65, p=0.02).
Conclusions:
- Objective performance metrics on specific da Vinci Surgical Skills Simulator tasks correlate with objective assessments during robotic-assisted radical prostatectomy.
- Basic robotic skills demonstrated in simulation are transferable to the operating room, validating simulator training for RARP.
- The study supports the use of simulator-based training for developing fundamental skills in urology residents undergoing RARP.
