Technical performance assessment of robotic surgery: a systematic scoping review

Area of Science:

• Robotic Surgery
• Surgical Skill Assessment
• Medical Error Analysis

Background:

• Assessing robotic surgery skill is crucial for patient safety and surgical proficiency.
• Standardized definitions of intraoperative technical errors are lacking.
• Current skill assessment methods vary widely in robotic surgery.

Purpose of the Study:

• To identify and categorize explicitly defined intraoperative technical errors in robotic surgery.
• To analyze how robotic surgery skill assessment is performed.
• To determine the methods used for rating performance, manual versus automated.

Main Methods:

• A scoping review of studies published from 2012 to May 2022.
• Searched MEDLINE, Embase, and Compendex databases.
• Included primary empirical and consensus-building studies on robotic surgery performance assessment and error definition.

Main Results:

• 185 studies were included, with most from the US and utilizing simulated or human robotic surgery settings.
• Performance errors were explicitly defined in 56% of included articles.
• Rating methods were split between manual (60%) and automated (40%) approaches.

Conclusions:

• There is considerable variation in performance measures for robotic surgery.
• Further conceptual development is required to explicitly define errors for robust robotic skill assessment.
• Objective, reliable performance measures, likely automated, are increasingly important for robotic surgery training and evaluation.