Development and validation of a composite scoring system for robot-assisted surgical training—the Robotic Skills Assessment Score

Chowriappa, Ashirwad; Shi, Yi; Raza, Syed Johar; Ahmed, Kamran; Stegemann, Andrew P.; Wilding, Gregory E.; Kaouk, Jihad; Peabody, James O.; Menon, Mani; Hassett, James M.; Kesavadas, Thenkurussi; Guru, Khurshid A.

doi:10.1016/j.jss.2013.06.054

Cited by 61 publications

(42 citation statements)

References 17 publications

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“…This provides an opportunity to use the VR to assess the skill of certified robotic surgeons at any time point. The ability to standardize assessments on a VR simulator has the potential to be used in re-credentialing of robotic surgeons [10,15,27,31]. In this application, a brief assessment on a VR simulator using a score such as the RSA may be enough to ensure that a practicing robotic surgeon is maintaining his/ her basic robotic surgical skill set, especially in cases where the volume of robotic surgical procedures performed in a period of time may fall below a threshold number.…”

Section: Discussionmentioning

confidence: 99%

“…Three groups have performed studies concluding that the RoSS is an appropriate training tool to develop robotic surgical skills [7][8][9][10]. Validation studies are presented in Table 1 …”

Section: Validationmentioning

confidence: 99%

“…In an effort to delineate real world performance metrics from others, Chowriappa et al [10] developed the Robotic Skills Assessment (RSA) score. This score provides users with a valid and standardized assessment tool for VR simulation.…”

Section: Other Usesmentioning

confidence: 99%

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Current state of virtual reality simulation in robotic surgery training: a review

et al. 2015

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There are many benefits to utilizing VR simulation for robotic skills acquisition. Four commercially available simulators have been demonstrated to be capable of assessing robotic skill. Three of the four simulators demonstrate the ability of a VR training curriculum to improve basic robotic skills, with proficiency-based training being the most effective training style. The skills obtained on a VR training curriculum are comparable with those obtained on dry laboratory simulation. The future of VR simulation includes utilization in assessment for re-credentialing purposes, advanced procedural-based training, and as a warm-up tool prior to surgery.

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Section: Discussionmentioning

confidence: 99%

“…Three groups have performed studies concluding that the RoSS is an appropriate training tool to develop robotic surgical skills [7][8][9][10]. Validation studies are presented in Table 1 …”

Section: Validationmentioning

confidence: 99%

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Current state of virtual reality simulation in robotic surgery training: a review

et al. 2015

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“…However, most of those obstacles had been overcome by the introduction of robotic technologies such as the da Vinci surgical system (DVSS)® (Intuitive Surgical, Mountain View, CA, USA). Robotic surgery allows intracorporeal maneuvers that mirror the natural dexterity of surgeons' hands with the additional advantages of eliminating the natural hand tremor [6][7][8]. Other significant benefits of using the robotic surgical system is the three-dimensional stereoscopic images and improved ergonomics for the primary surgeons in addition to the reduced discomfort for the patients who benefit from the minimally invasive approach and can return to their full functional capacity faster than open surgery [9].…”

Section: Innovationmentioning

confidence: 99%

Robotic Versus Open Renal Transplantation in Obese Patients: Protocol for a Cost-Benefit Markov Model Analysis (Preprint)

Molinari¹,

Puttarajappa²,

Wijkstrom³

et al. 2017

Preprint

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A Markov model will be developed to simulate a randomized controlled study to assess the costeffectiveness of robotic-assisted renal transplantation in comparison to open surgery in obese patients. Project SummaryThe number of patients affected by renal insufficiency and obesity is growing, especially in North America where obesity has reached epidemic proportions. Obesity is associated with several comorbidities that increase the risks of wound complications. Wound infections are one of the most common nosocomial complications in patients who undergo contaminated surgical procedures or who are immunosuppressed or diabetic. Often, obese patients who undergo renal transplantation have diabetes in addition to being immunosuppressed and develop some degree of wound complications (infections, seromas, dehiscence, hernias) in up to 50% of cases. Wound complications represent a significant clinical and economic burden to the health-care system. In particular, wound infections are responsible for longer hospitalizations and decreased functional capacity of renal transplant recipients who require extramural nursing for the management of their wound-vacuum devices and local debridement and packing of their incisions.

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“…We used a RoSS console [17,18] with its Fundamental Skills of Robotic Surgery (FSRS) curriculum [19,20] and HoST-based UVA in the study. The FSRS curriculum is a sequential, modular criterion-based structured curriculum for acquiring the basic skills of robot-assisted surgery.…”

Section: Robot-assisted Surgical Simulator and Fundamental Skills Of mentioning

confidence: 99%

Augmented‐reality‐based skills training for robot‐assisted urethrovesical anastomosis: a multi‐institutional randomised controlled trial

et al. 2014

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ObjectiveTo validate robot‐assisted surgery skills acquisition using an augmented reality (AR)‐based module for urethrovesical anastomosis (UVA).MethodsParticipants at three institutions were randomised to a Hands‐on Surgical Training (HoST) technology group or a control group. The HoST group was given procedure‐based training for UVA within the haptic‐enabled AR‐based HoST environment. The control group did not receive any training. After completing the task, the control group was offered to cross over to the HoST group (cross‐over group). A questionnaire administered after HoST determined the feasibility and acceptability of the technology. Performance of UVA using an inanimate model on the daVinci Surgical System (Intuitive Surgical Inc., Sunnyvale, CA, USA) was assessed using a UVA evaluation score and a Global Evaluative Assessment of Robotic Skills (GEARS) score. Participants completed the National Aeronautics and Space Administration Task Load Index (NASA TLX) questionnaire for cognitive assessment, as outcome measures. A Wilcoxon rank‐sum test was used to compare outcomes among the groups (HoST group vs control group and control group vs cross‐over group).ResultsA total of 52 individuals participated in the study. UVA evaluation scores showed significant differences in needle driving (3.0 vs 2.3; P = 0.042), needle positioning (3.0 vs 2.4; P = 0.033) and suture placement (3.4 vs 2.6; P = 0.014) in the HoST vs the control group. The HoST group obtained significantly higher scores (14.4 vs 11.9; P 0.012) on the GEARS. The NASA TLX indicated lower temporal demand and effort in the HoST group (5.9 vs 9.3; P = 0.001 and 5.8 vs 11.9; P = 0.035, respectively). In all, 70% of participants found that HoST was similar to the real surgical procedure, and 75% believed that HoST could improve confidence for carrying out the real intervention.ConclusionTraining in UVA in an AR environment improves technical skill acquisition with minimal cognitive demand.

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Development and validation of a composite scoring system for robot-assisted surgical training—the Robotic Skills Assessment Score

Cited by 61 publications

References 17 publications

Current state of virtual reality simulation in robotic surgery training: a review

Current state of virtual reality simulation in robotic surgery training: a review

Robotic Versus Open Renal Transplantation in Obese Patients: Protocol for a Cost-Benefit Markov Model Analysis (Preprint)

Augmented‐reality‐based skills training for robot‐assisted urethrovesical anastomosis: a multi‐institutional randomised controlled trial

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