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Emergency Undocking in Robotic Surgery: A Simulation Curriculum

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Simulation training in cesarean delivery.

Gunasegaran Rajan¹, Boon Nee Tang¹, Muniswaran Ganeshan¹

¹Obstetrical and Gynaecological Society of Malaysia, Kuala Lumpur, Malaysia.

American Journal of Obstetrics and Gynecology

|January 4, 2026

Summary

This summary is machine-generated.

This study developed a simulation-based cesarean delivery training program. The curriculum effectively improved surgical skills and patient safety in obstetrics across multiple countries.

Keywords:

B-Lynch suture Burns-Marshall C-Celia De Lee Google Classroom Joel-Cohen Lovset maneuver Mauriceau-Smellie-Veit Obstetric Phantom Set Patwardhan Pfannenstiel SimMom adult learning bladder injury breech cesarean surgical skills training classical incision complex cesarean consent cost-effective training module distance learning exteriorization of uterus fetal malpresentation hand prolapse impacted fetal head internal iliac ligation knitted uterine model language adaptability multiple pregnancy nontechnical skill obesity obstetrical leadership ovarian artery ligation placenta accreta spectrum disorder placenta previa prematurity pull and push technique robotic-based simulation safe cesarean second-stage cesarean simulation center simulation training skin incision surgical skills assessment transverse lie uterine artery ligation uterine compression suture uterine fibroid uterine incision uterine tears

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Area of Science:

Obstetrics and Gynecology
Surgical Education
Patient Safety

Background:

Cesarean delivery skills acquisition traditionally relies on apprenticeship, often lacking formal simulation.
Inadequate surgical skills and emergency knowledge compromise patient safety in obstetric procedures.
Simulation offers a risk-free environment for practicing essential obstetric surgical skills.

Purpose of the Study:

To develop and evaluate a standardized, simulation-based training curriculum for cesarean delivery.
To assess the effectiveness and adaptability of the training in diverse international settings.
To improve surgical skills and emergency management for obstetric emergencies.

Main Methods:

A multimodal curriculum combining online resources and hands-on simulation for core and complex cesarean skills.
Training covered surgical emergencies, postpartum hemorrhage management, and complications like hysterotomy extensions.
Simulation utilized varying fidelity equipment and a standardized training manual, incorporating adult learning principles and rapid feedback.

Main Results:

The simulation-based training demonstrated significant improvement in all 6 tested cesarean skills across participants.
The curriculum proved practical, adaptable, and cost-effective in Malaysia, Thailand, and Japan.
The training is reproducible and modifiable for international application, with positive participant feedback.

Conclusions:

Standardized simulation-based training is an effective method for improving cesarean delivery skills.
The developed curriculum is adaptable, practical, and cost-effective for global implementation.
Simulation training enhances obstetric surgical competence and patient safety.