Multi-perspective analysis of daVinci surgical virtual reality training: a prospective randomized controlled study

This study explored the impact of virtual reality (VR) training on improving the acquisition of basic robotic surgical skills by analyzing the effects of training in the daVinci Surgical System (dVSS) simulator from multiple perspectives. 27 subjects were randomly divided into a VR-training group and a control group, with the VR-training group (n = 12) receiving training on the dVSS simulator (XI) to achieve expert-specific proficiency status, and the control group (n = 15) receiving no training. All the subjects subsequently wore electroencephalography (EEG) equipment to perform 6 tasks and repeated 3 times on the dVSS simulator (SI). The Global Evaluative Assessment of Robotic Skills (GEARS) scores, dVSS scores, the National Aeronautics and Space Administration Task Load Index (NASA TLX) scores, and EEG data of all the subjects were collected to conduct a comprehensive and multi-perspective analysis for dVSS training. Learning curve analysis revealed that all trainees improved their basic robotic surgical skills and reached a steady state after training. Compared with the control group, the VR-training group received higher the GEARS scores (24.91 ± 3.36 vs. 19.68 ± 3.07; p < 0.01) and dVSS scores and lower the NASA TLX scores (40.04 ± 10.55 vs. 48.2 ± 9.88; p < 0.01). In the EEG analysis, the VR-training group had higher scores in the Beta band and the Low-gamma band in the brain regions and had greater energy activation than did the control group. This randomized controlled trial combined subjective and objective evaluations to comprehensively analyze subjects' technical and nontechnical skills. It demonstrated that training on the dVSS simulator significantly improved trainees' basic robotic surgical skills and that they could achieve better basic robotic surgical skills at lower workloads. Trial registration: The study was retrospectively registered at the Chinese Clinical Trial Center. The trial registration number (TRN) was ChiCTR2400088465, and the registration day was August 20, 2024.