Model Development of a Novel Robotic Surgery Training Exercise With Electrocautery

Lee, Christina S; Khan, Mustafa; Patnaik, Ronit; Stull, Mamie C.; Krell, Robert W.; Laverty, Robert B

doi:10.7759/cureus.24531

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…In the future, it may also be more helpful to focus on developing the speci c technical skills necessary for success in robotic surgery, rather than replicating the speci c simulated tasks. Previously, expert robotic surgeons have deconstructed robotic surgery into seven key elements: pick and place, two-handed transfer, wrist manipulation, camera control, clutching, suturing, and energy use [21,22]. An ideal home simulation kit can provide speci c practice for the technical skills of pick and place, two-handed transfer, and wrist manipulation.…”

Section: Discussionmentioning

confidence: 99%

Home practice for robotic surgery: A randomized controlled trial of a low-cost simulation model

Wile,

Brian,

Rodriguez

et al. 2023

Preprint

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PURPOSE Pre-operative simulated practice allows trainees to learn robotic surgery outside the operating room without risking patient safety. While simulation practice has shown efficacy, simulators are expensive and frequently inaccessible. Cruff (2021) described a low-cost simulation model to learn hand movements for robotic surgery. Our study evaluates whether practice with low-cost home simulation models can improve trainee performance on robotic surgery simulators. METHODS Home simulation kits were adapted from those described by Cruff (2021). Hand controllers were modified to mimic the master tool manipulators (MTMs) on the da Vinci Skills Simulator (dVSS). Medical students completed two da Vinci exercises: Sea Spikes 1 (SS1) and Big Dipper Needle Driving (BDND). They were subsequently assigned to either receive a home simulation kit or not. Students returned two weeks later and repeated SS1 and BDND. Overall score, economy of motion, time to completion, and penalty subtotal were collected, and analyses of covariance were performed. Semi-structured interviews assessed student perceptions of the robotic simulation experience. RESULTS Thirty-three medical students entered the study. Twenty-nine completed both sessions. The difference in score improvement between the experimental and control groups was not significant. In interviews, students provided suggestions to increase fidelity and usefulness of low-cost robotic home simulation. CONCLUSIONS Low-cost home simulation models did not improve student performance on dVSS after two weeks of at-home practice. Interview data highlighted areas to focus future simulation efforts. Ongoing work is necessary to develop low-cost solutions to facilitate practice for robotic surgery and foster more inclusive and accessible surgical education.

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Section: Discussionmentioning

confidence: 99%

Home practice for robotic surgery: A randomized controlled trial of a low-cost simulation model

Wile,

Brian,

Rodriguez

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…In the future, it may also be more helpful to focus on developing the specific technical skills necessary for success in robotic surgery, rather than replicating the specific simulated tasks. Previously, expert robotic surgeons have deconstructed robotic surgery into seven key elements: pick and place, two-handed transfer, wrist manipulation, camera control, clutching, suturing, and energy use [ 24 , 25 ]. An ideal home simulation kit can provide specific practice for the technical skills of pick and place, two-handed transfer, and wrist manipulation.…”

Section: Discussionmentioning

confidence: 99%

Home practice for robotic surgery: a randomized controlled trial of a low-cost simulation model

Wile,

Brian,

Rodriguez

et al. 2023

J Robotic Surg

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Pre-operative simulated practice allows trainees to learn robotic surgery outside the operating room without risking patient safety. While simulation practice has shown efficacy, simulators are expensive and frequently inaccessible. Cruff (J Surg Educ 78(2): 379–381, 2021) described a low-cost simulation model to learn hand movements for robotic surgery. Our study evaluates whether practice with low-cost home simulation models can improve trainee performance on robotic surgery simulators. Home simulation kits were adapted from those described by Cruff (J Surg Educ 78(2): 379–381, 2021). Hand controllers were modified to mimic the master tool manipulators (MTMs) on the da Vinci Skills Simulator (dVSS). Medical students completed two da Vinci exercises: Sea Spikes 1 (SS1) and Big Dipper Needle Driving (BDND). They were subsequently assigned to either receive a home simulation kit or not. Students returned two weeks later and repeated SS1 and BDND. Overall score, economy of motion, time to completion, and penalty subtotal were collected, and analyses of covariance were performed. Semi-structured interviews assessed student perceptions of the robotic simulation experience. Thirty-three medical students entered the study. Twenty-nine completed both sessions. The difference in score improvement between the experimental and control groups was not significant. In interviews, students provided suggestions to increase fidelity and usefulness of low-cost robotic home simulation. Low-cost home simulation models did not improve student performance on dVSS after two weeks of at-home practice. Interview data highlighted areas to focus future simulation efforts. Ongoing work is necessary to develop low-cost solutions to facilitate practice for robotic surgery and foster more inclusive and accessible surgical education.

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“…This was then secured to an electrocautery bovie pad within a robotic abdominal dome trainer. [20]. Participants were then asked to create a longitudinal enterotomy using electrocautery with monopolar scissors followed by closure with interrupted suture using the dots as landmarks on where to enter and exit the model.…”

Section: Methodsmentioning

confidence: 99%

Intentional enterotomies: validation of a novel robotic surgery training exercise

et al. 2023

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Purpose: While laparoscopic simulation-based training is a well-established component of general surgery training, no such requirement or standardized curriculum exists for robotic surgery. Furthermore, there is a lack of high-delity electrocautery simulation training exercises in the literature. Using Messick's validity framework, we sought to determine the content, response process, internal content and construct validity of a novel inanimate tissue model that utilizes electrocautery for potential incorporation in such curricula.Methods: Multi-institutional, prospective study involving medical students (MS) and general surgery residents (PGY1-3). Participants performed an exercise using a biotissue bowel model on the da Vinci Xi robotic console during which they created an enterotomy using electrocautery followed by approximation with interrupted sutures. Participant performance was recorded and then scored by crowd-sourced assessors of technical skill along with three of the authors. Construct validity was determined via difference in Global Evaluative Assessment of Robotic Skills (GEARS) score, time to completion and total number of errors between the two cohorts. Upon completion of the exercise, participants were surveyed on their perception of the exercise and its impact on their robotic training to determine content validity.Results: 31 participants were enrolled and separated into two cohorts: MS + PGY1 vs PGY2-3. Time spent on the robotic trainer (0.8 vs 8.13 hours, p=0.002), number of bedside robotic assists (5.7 vs 14.8, p<0.001), and number of robotic cases as primary surgeon (0.3 vs 13.1, p<0.001) were statistically signi cant between the two groups. Differences in GEARS scores (18.5 vs 19.9, p=0.001), time to completion (26.1 vs 14.4 min, p<0.001), and total errors (21.5 vs 11.9, p=0.018) between the groups were statistically signi cant as well. Of the 23 participants that completed the post-exercise survey, 87% and 91.3% reported improvement in robotic surgical ability and con dence, respectively. On a 10-point Likert scale, respondents rated the realism of the exercise 7.5, educational bene t 9.1, and effectiveness in teaching robotic skills 8.7. Controlling for the upfront investment of certain training materials, each exercise iteration cost ~$30.Conclusions: This study con rmed the content, response process, internal structure and construct validity of a novel, high-delity and cost-effective inanimate tissue exercise which successfully incorporates electrocautery. Consideration should be given to its addition to robotic surgery training programs.

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Model Development of a Novel Robotic Surgery Training Exercise With Electrocautery

Cited by 7 publications

References 17 publications

Home practice for robotic surgery: A randomized controlled trial of a low-cost simulation model

Home practice for robotic surgery: A randomized controlled trial of a low-cost simulation model

Home practice for robotic surgery: a randomized controlled trial of a low-cost simulation model

Intentional enterotomies: validation of a novel robotic surgery training exercise

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