Impact of Laparoscopic Experience on the Proficiency Gain of Urologic Surgeons in Robot-Assisted Surgery

Teishima, Jun; Hattori, Minoru; Inoue, Shogo; Ikeda, Kenichiro; Hieda, Keisuke; Miyamoto, Kengo; Shoji, Koichi; Hayashi, Tetsutaro; Kobayashi, Kanao; Kajiwara, Mitsuru; Egi, Hiroyuki; Ohdan, Hideki; Matsubara, Akio

doi:10.1089/end.2012.0308

Cited by 17 publications

(13 citation statements)

References 28 publications

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“…This score comparison showed that robot-assisted surgical skills were retained regardless of experience or certification (Table 3, Table 4). Combined with the results of our previous report, 5 our current findings suggest that robot-assisted surgery might be suitable for urologists without training or experience with laparoscopic surgery.…”

Section: Figsupporting

confidence: 84%

“…5 Participants were given 2 to 3 minutes to develop familiarity with the platform and the task prior to starting the first trial. All participants completed the program 4 consecutive times, with intervals for several minutes and then a fifth trial was completed 1 year later ( Fig.…”

Section: Simulator and Tasksmentioning

confidence: 99%

“…5 Thus, in the present study, to investigate the impact of laparoscopic surgery experience on the retention of robotassisted surgery skill, we compared the scores of a fifth trial completed after 1 year between certified and non-certified surgeons, as well as between those who had experience with a certain number of laparoscopic surgeries. This score comparison showed that robot-assisted surgical skills were retained regardless of experience or certification (Table 3, Table 4).…”

Section: Figmentioning

confidence: 99%

“…We previously reported that the fundamental techniques of robot-assisted surgery could be mastered regardless of familiarity with laparoscopic surgery. 5 Now, to clarify the actual usefulness of learning the skills associated with robotassisted surgery, it is essential to investigate not only the acquisition of the skills but also the rate of retention. Suh and colleagues reported that levels of retention improved after robot-assisted surgery training.…”

Section: Introductionmentioning

confidence: 99%

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Retention of robot-assisted surgical skills in urological surgeons acquired using Mimic dV-Trainer

Teishima

Hattori

Inoue

et al. 2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(7-8):e493-7. http://dx.doi.org/10.5489/cuaj.1993 Published online July 18, 2014. Abstract Introduction:We assess the retention of robot-assisted surgical skills among urologic surgeons. Methods: The robot-assisted surgery skills of 20 urologic surgeons were assessed using a Mimic dV-Trainer program (Mimic Technologies, Inc., Seattle, WA) consisting of 6 tasks. These 20 surgeons had no previous experience either using the Mimic dVTrainer or acting as the main surgeon in robot-assisted surgery. The surgeons completed the program 4 times in a row; after 1 year, they completed it again for a fifth time. Performance scores were recorded using the Mimic dV-Trainer's built-in algorithm. Results: For all 6 tasks, there were significant improvements to the scores in the fourth trials compared with those in the first trials. The scores in the fifth trials did not significantly decline compared with those in the fourth trials. There was no significant difference between the fifth trial scores of surgeons with laparoscopic surgery skills/experience and those without. Conclusion: Our results indicate that fundamental robot-assisted surgical skills can be retained in the long-term after they are acquired.

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Section: Figsupporting

confidence: 84%

Section: Simulator and Tasksmentioning

confidence: 99%

Section: Figmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Retention of robot-assisted surgical skills in urological surgeons acquired using Mimic dV-Trainer

Teishima

Hattori

Inoue

et al. 2014

CUAJ

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“…Indeed, when Teishima and colleagues compared certified expert laparoscopic urologists with novice laparoscopic urologists, significant differences in their performance on the suture sponge task of the dV-Trainer were only seen at the second and third trials, while there were no significant differences between the two groups at the first and fourth attempts. 17 This has several implications. First, even expert laparoscopic surgeons may need to become familiar with the robotic platform by performing a specific task.…”

Section: Discussionmentioning

confidence: 99%

Validation of the da Vinci Surgical Skill Simulator across three surgical disciplines

Alzahrani

Haddad

Alkhayal

et al. 2013

CUAJ

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Objective: In this paper, we evaluate face, content and construct validity of the da Vinci Surgical Skills Simulator (dVSSS) across 3 surgical disciplines. Methods: In total, 48 participants from urology, gynecology and general surgery participated in the study as novices (0 robotic cases performed), intermediates (1-74) or experts (≥75). Each participant completed 9 tasks (Peg board level 2, match board level 2, needle targeting, ring and rail level 2, dots and needles level 1, suture sponge level 2, energy dissection level 1, ring walk level 3 and tubes). The Mimic Technologies software scored each task from 0 (worst) to 100 (best) using several predetermined metrics. Face and content validity were evaluated by a questionnaire administered after task completion. Wilcoxon test was used to perform pair wise comparisons. Results: The expert group comprised of 6 attending surgeons. The intermediate group included 4 attending surgeons, 3 fellows and 5 residents. The novices included 1 attending surgeon, 1 fellow, 13 residents, 13 medical students and 2 research assistants. The median number of robotic cases performed by experts and intermediates were 250 and 9, respectively. The median overall realistic score (face validity) was 8/10. Experts rated the usefulness of the simulator as a training tool for residents (content validity) as 8.5/10. For construct validity, experts outperformed novices in all 9 tasks (p < 0.05). Intermediates outperformed novices in 7 of 9 tasks (p < 0.05); there were no significant differences in the energy dissection and ring walk tasks. Finally, experts scored significantly better than intermediates in only 3 of 9 tasks (matchboard, dots and needles and energy dissection) (p < 0.05). Conclusions: This study confirms the face, content and construct validities of the dVSSS across urology, gynecology and general surgery. Larger sample size and more complex tasks are needed to further differentiate intermediates from experts. IntroductionThe American College of Surgeons has recommended simulation-based training for surgical trainees to increase proficiency and patient safety in light of recent restrictions to trainee work hours and increased concerns over patient safety.1 The first validated low-fidelity objective training and assessment tool for basic laparoscopic skills is the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS), which has been adapted by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) for the Fundamentals of Laparoscopic Surgery (FLS) program.2 Currently, FLS certification is required for candidates applying for certification from the American Board of Surgery. Furthermore, construct validity of MISTELS has been established for urology trainees and attending urologists.3 Recently, the American Urological Association's Committee on Laparoscopy, Robotic and New Technology modified the original MISTELS/FLS program into a more urocentric curriculum, the Basic Laparoscopic Urologic Surgery (BLUS) skills curriculu...

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Laparoscopic but not open surgical skills can be transferred to robot‐assisted surgery: A systematic review and meta‐analysis

Schmidt,

Fan,

Köppinger

et al. 2023

World j. surg.

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BackgroundWith an increase in robot‐assisted surgery across all specialties, adequate training and credentialing strategies need to be identified to ensure patients safety. The meta‐analysis assesses the transferability of technical surgical skills between laparoscopic surgery, open surgery, and robot‐assisted surgery.DesignA systematic search was conducted in Medline, Cochrane Central Register of Controlled Trials, and Web of Science. Outcomes were categorized into time, process, product, and composite outcome measures and pooled separately using Hedges'g (standardized mean difference [SMD]). Subgroup analyses were performed to assess the effect of study design, virtual reality platforms and task difficulty.ResultsOut of 14,120 screened studies, 30 were included in the qualitative synthesis and 26 in the quantitative synthesis. Technical surgical skill transfer was demonstrated from laparoscopic to robot‐assisted surgery (composite: SMD 0.40, 95%‐confidence interval [CI] [0.19; 0.62], time: SMD 0.62, CI [0.33; 0.91]) and vice versa (composite: SMD 0.66, CI [0.33; 0.99], time [basic skills]: SMD 0.36, CI [0.01; 0.72]). No skill transfer was seen from open to robot‐assisted surgery with limited available data.ConclusionTechnical surgical skills can be transferred from laparoscopic to robot‐assisted surgery and vice versa. Robot‐assisted and laparoscopic surgical skills training and credentialing should not be regarded separately, but a reasonable combination could shorten overall training times and increase efficiency. Previous experience in open surgery should not be considered as an imperative prerequisite for training in robot‐assisted surgery. Recommendations for studies assessing skill transfer are proposed to increase comparability and significance of future studies.PROSPERO Registration NumberPROSPERO CRD42018104507.

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Impact of Laparoscopic Experience on the Proficiency Gain of Urologic Surgeons in Robot-Assisted Surgery

Abstract: Our data indicate that familiarity with laparoscopic surgery is not associated with any advantage in learning the most fundamental techniques of robot-assisted surgery.

Cited by 17 publications

References 28 publications

Retention of robot-assisted surgical skills in urological surgeons acquired using Mimic dV-Trainer

Retention of robot-assisted surgical skills in urological surgeons acquired using Mimic dV-Trainer

Validation of the da Vinci Surgical Skill Simulator across three surgical disciplines

Laparoscopic but not open surgical skills can be transferred to robot‐assisted surgery: A systematic review and meta‐analysis

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