Transfer of open and laparoscopic skills to robotic surgery: a systematic review

Abstract

Due to its advantages over open surgery and conventional laparoscopy, uptake of robot-assisted surgery has rapidly increased. It is important to know whether the existing open or laparoscopic skills of robotic novices shorten the robotic surgery learning curve, potentially reducing the amount of training required. This systematic review aims to assess psychomotor skill transfer to the robot in clinical and simulated settings. PubMed, EMBASE, Cochrane Library and Scopus databases were systematically searched in accordance with PRISMA guidelines from inception to August 2021 alongside website searching and citation chaining. Article screening, data extraction and quality assessment were undertaken by two independent reviewers. Outcomes included simulator performance metrics or in the case of clinical studies, peri- and post-operative metrics. Twenty-nine studies met the eligibility criteria. All studies were judged to be at high or moderate overall risk of bias. Results were narratively synthesised due to heterogeneity in study designs and outcome measures. Two of the three studies assessing open surgical skill transfer found evidence of successful skill transfer while nine of twenty-seven studies evaluating laparoscopic skill transfer found no evidence. Skill transfer from both modalities is most apparent when advanced robotic tasks are performed in the initial phase of the learning curve but quality and methodological limitations of the existing literature prevent definitive conclusions. The impact of incorporating laparoscopic simulation into robotic training curricula and on the cost effectiveness of training should be investigated.

Robotic Plastic Surgery Education: Developing a Robotic Surgery Training Program Specific to Plastic Surgery Trainees

“…The dVSS is the most widely utilized simulator among hospital institutions, and the DV-Trainer is the most robustly validated, displaying face, content, and construct validity. 19 25 34…”

“…25 35 Chahal et al conducted a systematic review that found trainees' open surgical skills successfully transferred to the robotic setting, with skill transfer measured by higher performance metrics in trainees with previous open surgery experience. 25 The authors attribute knowledge of anatomy and approaches for operating in a certain region as contributory to the successful skill transfer from open surgery. 25…”

“…25 The authors attribute knowledge of anatomy and approaches for operating in a certain region as contributory to the successful skill transfer from open surgery. 25…”

“…VR surgical simulators available for purchase include the da Vinci Surgical Skills Stimulator (dVSS; Intuitive Surgical, Sunnyvale, CA), the DV-Trainer (Mimic Technologies Inc., Seattle, WA), the Robotix Mentor (Symbionix), and the new Ross II (Simulated Surgical System). 25 Simulators cost upward of $100,000, which can limit access for residency programs. The dVSS is the most widely utilized simulator among hospital institutions, and the DV-Trainer is the most robustly validated, displaying face, content, and construct validity.…”

“…The dVSS is the most widely utilized simulator among hospital institutions, and the DV-Trainer is the most robustly validated, displaying face, content, and construct validity. 19,25,34 Each VR system has compatible curriculum modules that introduce the learner to basic robotic skills and functionalities. Generally, VR curriculum includes a series of tasks such as instrument and camera control, robotic arm control, third-arm functionality, EndoWrist manipulation, needle handling, electrocautery, tissue handling, blunt dissection, vessel dissection, and knot tying.…”