Use of Robotic Anastomosis Competency Evaluation (RACE) tool for assessment of surgical competency during urethrovesical anastomosis

Khan, Hassan A.; Kozlowski, Justen; Hussein, Ahmed A.; Sharif, Mohamed; Ahmed, Youssef; May, Paul; Hammond, Yana; Stone, Kevin; Ahmad, Basim; Cole, Adam; Hasasneh, Adam; Raheem, Sana

doi:10.5489/cuaj.5348

Cited by 8 publications

(7 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Two blinded surgeons assessed the anonymised video recordings of the task, using the GEARS and Robotic Anastomosis Competency Evaluation (RACE) [ 29 ] scores. The 14 participants were stratified, this time into two groups by caseload, into expert and novice groups.…”

Section: Discussionmentioning

confidence: 99%

3D printed patient-specific prostate cancer models to guide nerve-sparing robot-assisted radical prostatectomy: a systematic review

et al. 2022

View full text Add to dashboard Cite

Precise knowledge of each patient’s index cancer and surrounding anatomy is required for nerve-sparing robot-assisted radical prostatectomy (NS-RARP). Complementary to this, 3D printing has proven its utility in improving the visualisation of complex anatomy. This is the first systematic review to critically assess the potential of 3D printed patient-specific prostate cancer models in improving visualisation and the practice of NS-RARP. A literature search of PubMed and OVID Medline databases was performed using the terms “3D Printing”, “Robot Assisted Radical Prostatectomy” and related index terms as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight articles were included; six were identified via database searches, to which a further two articles were located via a snowballing approach. Eight papers were identified for review. There were five prospective single centre studies, one case series, one technical report and one letter to the editor. Of these articles, five publications (62.5%) reported on the utility of 3D printed models for NS-RARP planning. Two publications (25%) utilised 3D printed prostate models for simulation and training, and two publications (25%) used the models for patient engagement. Despite the nascency of the field, 3D printed models are emerging in the uro-oncological literature as a useful tool in visualising complex anatomy. This has proven useful in NS-RARP for preoperative planning, simulation and patient engagement. However, best practice guidelines, the future regulatory landscape, and health economic considerations need to be addressed before this synergy of new technologies is ready for the mainstream.

show abstract

Section: Discussionmentioning

confidence: 99%

3D printed patient-specific prostate cancer models to guide nerve-sparing robot-assisted radical prostatectomy: a systematic review

et al. 2022

View full text Add to dashboard Cite

show abstract

“…RACE is a RARP‐specific tool that has been used to evaluate UVA in both simulation and live surgery . Khan et al demonstrated improved RACE scores for those with greater clinical experience during their training on live patients. While RACE scores identify task‐specific assessment of the UVA, there remains a subjective component for standardized assessment, such as dexterity or needle positioning during anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Incorporation and validation of clinically relevant performance metrics of simulation (CRPMS) into a novel full‐immersion simulation platform for nerve‐sparing robot‐assisted radical prostatectomy (NS‐RARP) utilizing three‐dimensional printing and hydrogel casting technology

et al. 2019

View full text Add to dashboard Cite

ObjectivesTo incorporate and validate clinically relevant performance metrics of simulation (CRPMS) into a hydrogel model for nerve-sparing robot-assisted radical prostatectomy (NS-RARP). Materials and MethodsAnatomically accurate models of the human pelvis, bladder, prostate, urethra, neurovascular bundle (NVB) and relevant adjacent structures were created from patient MRI by injecting polyvinyl alcohol (PVA) hydrogels into threedimensionally printed injection molds. The following steps of NS-RARP were simulated: bladder neck dissection; seminal vesicle mobilization; NVB dissection; and urethrovesical anastomosis (UVA). Five experts (caseload >500) and nine novices (caseload <50) completed the simulation. Force applied to the NVB during the dissection was quantified by a novel tension wire sensor system fabricated into the NVB. Post-simulation margin status (assessed by induction of chemiluminescent reaction with fluorescent dye mixed into the prostate PVA) and UVA weathertightness (via a standard 180-mL leak test) were also assessed. Objective scoring, using Global Evaluative Assessment of Robotic Skills (GEARS) and Robotic Anastomosis Competency Evaluation (RACE), was performed by two blinded surgeons. GEARS scores were correlated with forces applied to the NVB, and RACE scores were correlated with UVA leak rates. Incorporating clinical metrics in a RARP model sparing radical prostatectomy and fruit for simple prostatectomy. Korean J Urol 2011; 52: 130-5 34 Clarebrough E, Christidis D, Lindner U, Fernandes K, Fleshner N, Lawrentschuk N. Analysis of a practical surgical skills laboratory for nerve sparing radical prostatectomy. World J Urol 2019; 37: 799-804

show abstract

“…It also remains reliant on assessor subjectivity and human rating which introduces the risk of bias [ 4 ]. Another tool, the Robotic Anastomosis Competency Evaluation (RACE), is a validated, objective scoring system to assess surgical performance during ureterovesical anastomosis (UVA) and provide structured feedback [ 9 ]. Whilst UVA is a critical step in surgical procedures, such as robot-assisted radical prostatectomy (RARP), it represents one task and not an entire procedure [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Another tool, the Robotic Anastomosis Competency Evaluation (RACE), is a validated, objective scoring system to assess surgical performance during ureterovesical anastomosis (UVA) and provide structured feedback [ 9 ]. Whilst UVA is a critical step in surgical procedures, such as robot-assisted radical prostatectomy (RARP), it represents one task and not an entire procedure [ 9 , 10 ]. Collectively, there is a need for clinically relevant objective metrics which can quantify a surgeon’s performance, provide feedback and ultimately improve both surgical and patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

What are clinically relevant performance metrics in robotic surgery? A systematic review of the literature

Younes

Larkins

et al. 2022

J Robotic Surg

View full text Add to dashboard Cite

A crucial element of any surgical training program is the ability to provide procedure-specific, objective, and reliable measures of performance. During robotic surgery, objective clinically relevant performance metrics (CRPMs) can provide tailored contextual feedback and correlate with clinical outcomes. This review aims to define CRPMs, assess their validity in robotic surgical training and compare CRPMs to existing measures of robotic performance. A systematic search of Medline and Embase databases was conducted in May 2022 following the PRISMA guidelines. The search terms included Clinically Relevant Performance Metrics (CRPMs) OR Clinically Relevant Outcome Measures (CROMs) AND robotic surgery. The study settings, speciality, operative context, study design, metric details, and validation status were extracted and analysed. The initial search yielded 116 citations, of which 6 were included. Citation searching identified 3 additional studies, resulting in 9 studies included in this review. Metrics were defined as CRPMs, CROMs, proficiency-based performance metrics and reference-procedure metrics which were developed using a modified Delphi methodology. All metrics underwent both contents and construct validation. Two studies found a strong correlation with GEARS but none correlated their metrics with patient outcome data. CRPMs are a validated and objective approach for assessing trainee proficiency. Evaluating CRPMs with other robotic-assessment tools will facilitate a multimodal metric evaluation approach to robotic surgery training. Further studies should assess the correlation with clinical outcomes. This review highlights there is significant scope for the development and validation of CRPMs to establish proficiency-based progression curricula that can be translated from a simulation setting into clinical practice.

show abstract

Use of Robotic Anastomosis Competency Evaluation (RACE) tool for assessment of surgical competency during urethrovesical anastomosis

Abstract: Trainee RACE scores improved and proportion of UVA performed by trainees increased over time. RACE can be used as an objective measure of surgical performance during training. Strict mentor supervision allowed safe training without compromising patient outcomes.

Cited by 8 publications

References 18 publications

3D printed patient-specific prostate cancer models to guide nerve-sparing robot-assisted radical prostatectomy: a systematic review

3D printed patient-specific prostate cancer models to guide nerve-sparing robot-assisted radical prostatectomy: a systematic review

Incorporation and validation of clinically relevant performance metrics of simulation (CRPMS) into a novel full‐immersion simulation platform for nerve‐sparing robot‐assisted radical prostatectomy (NS‐RARP) utilizing three‐dimensional printing and hydrogel casting technology

What are clinically relevant performance metrics in robotic surgery? A systematic review of the literature

Contact Info

Product

Resources

About