Active control time: an objective performance metric for trainee participation in robotic surgery

Area of Science:

• Surgical Education
• Robotic Surgery
• Medical Technology Assessment

Background:

• Trainee participation in robotic general surgery is not well-defined.
• Objective metrics are needed to track performance in computer-assisted surgery.

Purpose of the Study:

• To validate active control time (ACT) as a novel metric for assessing trainee involvement in robotic-assisted surgeries.
• To analyze the relationship between trainee level, case complexity, and ACT.

Main Methods:

• Retrospective analysis of da Vinci Surgical System data from 123 robotic cases over 10 months.
• Inclusion of 18 general surgery residents and 1 fellow.
• Calculation of percent ACT (trainee console time / total active console time) and statistical analysis using Kruskal-Wallis and Mann-Whitney U tests.

Main Results:

• Median %ACT significantly increased with trainee level (PGY1 to fellow, p < 0.0001).
• Median %ACT was higher in standard cases than complex cases for PGY5 residents (60% vs. 36%, p = 0.0002) and fellows (74% vs. 47%, p = 0.0045).

Conclusions:

• Active control time (ACT) is a valid, objective measure of trainee participation in robotic surgery.
• ACT demonstrates increasing proficiency with trainee level and differences based on case complexity.
• Further research into task-specific ACT can refine robotic surgical training and performance evaluation.