Simulator Fidelity Does Not Affect Training for Robot-Assisted Minimally Invasive Surgery

This study was undertaken to compare performance using a surgical robot after training with one of three simulators of varying fidelity.

Eight novice operators and eight expert surgeons were randomly assigned to one of three simulators. Each participant performed two exercises using a simulator and then using a surgical robot. The primary outcome of this study is performance assessed by time and GEARS score.

Participants were randomly assigned to one of three simulators. Time to perform the suturing exercise (novices vs. experts) was significantly different for all 3 simulators. Using the da Vinci robot, peg transfer showed no significant difference between novices and experts and all participants combined (mean time novice 2.00, expert 2.21, p = 0.920). The suture exercise had significant differences in each group and all participants combined (novice 3.54, expert 1.90, p = 0.001). ANOVA showed p-Values for suturing (novice 0.523, expert 0.123) and peg transfer (novice 0.742, expert 0.131) are not significantly different. GEARS scores were different (p < 0.05) for novices and experts.

Training with simulators of varying fidelity result in similar performance using the da Vinci robot. A dry box simulator may be as effective as a virtual reality simulator for training. Further studies are needed to validate these results.