Performance of robotic simulated skills tasks is positively associated with clinical robotic surgical performance

Abstract

ObjectiveTo compare user performance of four fundamental inanimate robotic skills tasks (FIRST) as well as eight da Vinci Skills Simulator (dVSS) virtual reality tasks with intra-operative performance (concurrent validity) during robot-assisted radical prostatectomy (RARP) and to show that a positive correlation exists between simulation and intra-operative performance. Materials and MethodsA total of 21 urological surgeons with varying robotic experience were enrolled. Demographics were captured using a standardized questionnaire. User performance was assessed concurrently in simulated (FIRST exercises and dVSS tasks) and clinical environments (endopelvic dissection during RARP). Intra-operative robotic clinical performance was scored using the previously validated sixmetric Global Evaluative Assessment of Robotic Skills (GEARS) tool. The relationship between simulator and clinical performance was evaluated using Spearman's rank correlation. ResultsPerformance was assessed in 17 trainees and four expert robotic surgeons with a median (range) number of previous robotic cases (as primary surgeon) of 0 (0-55) and 117 (58-600), respectively (P = 0.001). Collectively, the overall FIRST (q = 0.833, P < 0.001) and dVSS (q = 0.805, P < 0.001) simulation scores correlated highly with GEARS performance score. Each individual FIRST and dVSS task score also demonstrated a significant correlation with intra-operative performance, with the exception of Energy Switcher 1 exercise (P = 0.063). ConclusionsThis is the first study to show a significant relationship between simulated robotic performance and robotic clinical performance. Findings support implementation of these robotic training tools in a standardized robotic training curriculum.

Robotic simulation: are we ready to go?

“…In a study in this issue of BJUI, Aghazadeh et al [1] were able to show that there was a significant relationship between simulated robotic performance and robotic clinical performance. The authors conclude that this supports the implementation of such robotic training tools in a standardized robotic training curriculum.…”

“…For this, the dream scenario would be the ability to simulate a surgical procedure before being allowed to perform the real operation on the patient, similarly to pilots being trained on a flight simulator [3]. A robotic (virtual) simulator would be the ideal way to provide training on the respective robot-assisted procedure [1].…”

“…The authors are to be congratulated in their effort to prove the transfer validity of their training model using 12 previously validated robotic skill tasks consisting of four inanimate models and eight selected virtual reality tasks on the da Vinci Skills Simulator [1]. Endopelvic fascial dissection during robot-assisted radical prostatectomy was chosen to assess clinical robotic performance.…”

“…The authors [1] identify several critical aspects of posttreatment prostate cancer survivors. First, more than half of patients needed more information about their symptoms.…”

Setting up a pediatric robotic urology program: A USA institution experience

“…In fact, Aghazadeh et al . have shown that there is a positive correlation between performance on robotic simulator tasks and intraoperative performance of robotic radical prostatectomy, and it is likely that this correlation extends to most procedures . In pediatric RALS, any erroneous movement by the surgeon on the console or the bedside assistant can lead to tissue injury and adjacent organ damage.…”