Virtual reality simulations in robotic surgery training: a systematic review and meta-analysis

Area of Science:

• Medical Simulation
• Surgical Education
• Robotics

Background:

• Traditional surgical training methods are evolving with technological advancements.
• Virtual reality (VR) offers a promising avenue for skill acquisition in complex procedures.
• Objective assessment of training efficacy is crucial for validating new methodologies.

Purpose of the Study:

• To systematically compare the effectiveness of virtual reality (VR) simulations against other training modalities.
• To evaluate improvements in objective assessment scores and task completion times.
• To determine the optimal role of VR in surgical training programs.

Main Methods:

• A comprehensive database search was performed across major scientific repositories (Central, MEDLINE, EMBASE, Web of Science, Scopus) on May 20, 2024.
• Included were randomized controlled trials comparing VR simulations with alternative training methods, focusing on objective skill assessments and time-based metrics.
• The Risk of Bias-2 tool was employed to critically appraise the quality of the included studies.

Main Results:

• Eighteen studies involving 339-357 participants were analyzed.
• VR training significantly enhanced objective scores (SMD 1.04) and reduced task completion times (SMD -1.08) compared to no additional training.
• VR demonstrated comparable effectiveness to dry lab training for both objective scores (SMD -0.47) and task times (SMD -0.37), but wet lab training showed a significant reduction in task times compared to VR in one study.

Conclusions:

• Virtual reality (VR) simulation is more effective than no additional training for robotic skill acquisition.
• VR training is as effective as traditional dry lab training in improving surgical skills.
• The findings support the expanded integration of VR into surgical training curricula to enhance robotic surgery proficiency.