3D straight-stick laparoscopy versus 3D robotics for task performance in novice surgeons: a randomised crossover trial

Shakir, Fevzi; Jan, Haider; Kent, Andrew

doi:10.1007/s00464-016-4893-y

Cited by 11 publications

(9 citation statements)

References 19 publications

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“…The current study provides objective evidence that suture task performance by surgically naïve participants is enhanced by robotic assistance compared to CL. This is in agreement with previous investigations that studied participants with varying levels of surgical experience (2)(3)(4)(5)16). Specifically, our study demonstrated superior performance in suture tension (P < 0.05) and a greater number of participants who were able to complete FTS under 3-D visualization as compared with CL.…”

Section: Discussionsupporting

confidence: 92%

“…In addition to supporting reduced analgesic use, a faster recovery period, and fewer wound complications, robotic surgery can reduce the length of hospital stay and require fewer conversions than conventional laparoscopy (CL) . Although there have been few clinical studies assessing the benefits of robotic surgery, the results of experimental studies have shown that robotic assistance has clear advantages, including enhanced surgical task performance . Three‐dimensional visualization is a standard feature of today's robotic systems and improves surgical performance independent of surgical method .…”

Section: Introductionmentioning

confidence: 99%

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Objective assessment of robotic suturing skills with a new computerized system: A step forward in the training of robotic surgeons

Busch

Nakadate

Uemura

et al. 2018

Asian J Endoscop Surgery

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Introduction The purpose of this study was to assess robot‐assisted suturing skills on a laparoscopic intestinal anastomosis model by using a novel computerized objective assessment system. Methods This study compared the suturing skills of 13 surgically naïve participants on an artificial intestinal anastomosis model that mimics real tissue. Each examinee sutured using da Vinci robot assistance under 2‐D and 3‐D visualization and with conventional laparoscopy (CL). Pressure‐measuring and image‐processing devices were employed to quantitatively evaluate suturing skills. Five unique criteria were used to evaluate the skills of participants. Results Suturing under 3‐D visualization (P < 0.01) and with CL (P < 0.05) were significantly faster than under 2‐D visualization. Sutures placed under 3‐D (P < 0.05) and 2‐D (P < 0.01) visualization had significantly better suture tension than those placed with CL, which did not meet acceptable values for suture tension. Sutures placed with CL had significantly better air pressure leakage than those placed under 2‐D visualization (P < 0.05), which did not meet acceptable values for air pressure leakage and wound opening area. One participants failed to achieve full‐thickness sutures with 2‐D, two participants with CL, and one participant with 3‐D. Conclusion Using 3‐D vision is necessary for complex maneuvering during robot‐assisted minimally invasive surgery. Our quantitative assessment system is useful for evaluating the skill acquisition of surgeon‐trainees undergoing robotic surgery training.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Objective assessment of robotic suturing skills with a new computerized system: A step forward in the training of robotic surgeons

Busch

Nakadate

Uemura

et al. 2018

Asian J Endoscop Surgery

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“…Motion smoothness boxplot diagrams of experienced and non-experienced groups in rope race, precision cutting, and basic suturing tasks, with reduced error rates and quicker task performance times. 21 Due to the low number of repetitions of every exercise in this study, we were not able to draw and compare learning curves with 3D and 2D in simulation training. Further studies on learning curves in box training should be able to demonstrate any differences in learning.…”

Section: Discussionmentioning

confidence: 93%

Can 3D Vision Improve Laparoscopic Performance in Box Simulation Training when Compared to Conventional 2D Vision?

Österberg¹,

Sokratous²,

Γεωργίου³

et al. 2019

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Introduction: Three-dimensional (3D) imaging systems have been introduced in laparoscopic surgery to facilitate binocular vision and dexterity to improve surgical performance and safety. Several studies have shown the benefits of 3D imaging in laparoscopy, but until now only a few studies have assessed the outcome by using objective variables. Box trainers are affordable alternatives to virtual laparoscopic surgical training, and the possibility of using real surgical instruments makes them more realistic to use. However, the data and feedback by a virtual simulator have not, until now, been able to assess. Simball Box®, equipped with G-coder sensors®, registers the instrument movements during training and gives the same feedback like a virtual simulator. Aim:The aim of this study was to objectively evaluate the laparoscopic performance in 3D compared to conventional 2D vision by using a box simulation trainer. Materials and methods:Thirty surgeons, residents and consultants, participated in the study. Eighteen had no, or minimal, laparoscopic experience (novices) whereas 12 were experts. They all performed three standard box training exercises (rope race, precision cutting, and basic suturing) in Simball Box. The participants were randomized and started with either 3D HD or traditional 2D HD cameras. The exercises were instructed and supervised. All instrument movements were registered. Variations in time, linear distance, average speed, and motion smoothness were analyzed. Results:The parameters time, distance, speed, and motion smoothness were significantly better when the 3D camera was used.Conclusion: All individuals of both subgroups achieved significantly higher speed and better motion smoothness when using 3D.

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“…As major triangulation is helpful for these exercises, SymphonX may have been superior here. Shakir et al could demonstrate an advantage of robotics for novices performing the task recapping [37]. Here it was assumed that the advantages of robotics are more effective in more complex exercises like recapping.…”

Section: Discussionmentioning

confidence: 99%

Learning curve of surgical novices using the single-port platform SymphonX: minimizing OR trauma to only one 15-mm incision

et al. 2020

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Background Minimally invasive single-port surgery is always associated with large incisions up to 2–3 cm, complicated handling due to the lack of triangulation, and instrument crossing. The aim of this prospective study was to report how medical students without any laparoscopic experience perform several laparoscopic tasks (rope pass, paper cut, peg transfer, recapping, and needle threading) with the new SymphonX single-port platform and to examine the learning curves in comparison to the laparoscopic multi-port technique. Methods A set of 5 laparoscopic skill tests (Rope Pass, Paper cut, Peg Transfer, Recapping, Needle Thread) were performed with 3 repetitions. Medical students performed all tests with both standard laparoscopic instruments and the new platform. Time and errors were recorded. Results A total of 114 medical students (61 females) with a median age of 23 years completed the study. All subjects were able to perform the skill tests with both standard laparoscopic multi-port and the single-port laparoscopic system and were able to significantly improve their performance over the three trials for all five tasks—rope pass (p < 0.001), paper cut (p < 0.001), peg transfer (p < 0.001), needle threading (p < 0.001), and recapping (p < 0.001). In 3 out of 5 tasks, medical students performed the tasks faster using the standard multi-port system—rope pass (p < 0.001), paper cut (p < 0.001), and peg transfer (p < 0.001). In the task recapping, medical students performed the task faster using the new single-port system (p = 0.003). In the task needle threading, there was no significant difference between the standard multi-port system and the new single-port system (p > 0.05). Conclusion This is the first study analyzing learning curves of the commercially available SymphonX platform for abdominal laparoscopic surgery when used by novices. The learning curve and the error rate are promising.

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3D straight-stick laparoscopy versus 3D robotics for task performance in novice surgeons: a randomised crossover trial

Abstract: Our study has shown that for novice surgeons, there is a significant benefit in a simulated setting of 3D robotic systems over 3D straight-stick laparoscopy, in terms of reduced error rate and quicker task performance time.

Cited by 11 publications

References 19 publications

Objective assessment of robotic suturing skills with a new computerized system: A step forward in the training of robotic surgeons

Objective assessment of robotic suturing skills with a new computerized system: A step forward in the training of robotic surgeons

Can 3D Vision Improve Laparoscopic Performance in Box Simulation Training when Compared to Conventional 2D Vision?

Learning curve of surgical novices using the single-port platform SymphonX: minimizing OR trauma to only one 15-mm incision

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