1. Fundamental skills of robotic surgery: a multi-institutional randomized controlled trial for validation of a simulation-based curriculum
- Author
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Thenkurussi Kesavadas, Kamran Ahmed, Ashirwad Chowriappa, Khurshid R. Ghani, Andrew P. Stegemann, Amrith Raj Rao, Gregory E. Wilding, James M. Hassett, Yi Shi, Johar R. Syed, Shabnam Rehman, Jihad H. Kaouk, James O. Peabody, Mani Menon, Ricardo Autorino, Khurshid A. Guru, Mohamed Sharif, Stegemann, Ap, Ahmed, K, Syed, Jr, Rehman, S, Ghani, K, Autorino, Riccardo, Sharif, M, Rao, A, Shi, Y, Wilding, Ge, Hassett, Jm, Chowriappa, A, Kesavadas, T, Peabody, Jo, Menon, M, Kaouk, J, and Guru, Ka
- Subjects
Laparoscopic surgery ,Adult ,medicine.medical_specialty ,Virtual reality simulator ,Urology ,medicine.medical_treatment ,Da Vinci Surgical System ,law.invention ,Randomized controlled trial ,law ,medicine ,Humans ,Robotic surgery ,Computer Simulation ,Surgical simulator ,Curriculum ,Simulation based ,business.industry ,Robotics ,Surgery ,Physical therapy ,Urologic Surgical Procedures ,Clinical Competence ,Educational Measurement ,business - Abstract
To develop and establish effectiveness of simulation-based robotic curriculum--fundamental skills of robotic surgery (FSRS).FSRS curriculum was developed and incorporated into a virtual reality simulator, Robotic Surgical Simulator (RoSS). Fifty-three participants were randomized into an experimental group (EG) or control group (CG). The EG was asked to complete the FSRS and 1 final test on the da Vinci Surgical System (dVSS). The dVSS test consisted of 3 tasks: ball placement, suture pass, and fourth arm manipulation. The CG was directly tested on the dVSS then offered the chance to complete the FSRS and re-tested on the dVSS as a crossover (CO) group.Sixty-five percent of participants had never formally trained using laparoscopic surgery. Ball placement: the EG demonstrated shorter time (142 vs 164 seconds, P = .134) and more precise (1.5 vs 2.5 drops, P = .014). The CO took less time (P.001) with greater precision (P.001). Instruments were rarely lost from the field. Suture pass: the EG demonstrated better camera utilization (4.3 vs 3.0, P = .078). Less instrument loss occurred (0.5 vs 1.1, P = .026). Proper camera usage significantly improved (P = .009). Fourth arm manipulation: the EG took less time (132 vs 157 seconds, P = .302). Meanwhile, loss of instruments was less frequent (0.2 vs 0.8, P = .076). Precision in the CO improved significantly (P = .042) and camera control and safe instrument manipulation showed improvement (1.5 vs 3.5, 0.2 vs 0.9, respectively).FSRS curriculum is a valid, feasible, and structured curriculum that demonstrates its effectiveness by significant improvements in basic robotic surgery skills.
- Published
- 2012